WILLIAM B. EVANS, M.D., S.C. EMPLOYEES' PENSION PLAN
|
2011
|
363161765
|
2013-07-08
|
WILLIAM B. EVANS, M.D., S.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7738786000
|
Plan sponsor’s
address |
3740 N. LAKE SHORE DRIVE, APT. 8A, CHICAGO, IL, 606134201
|
Plan administrator’s name and address
Administrator’s EIN |
363161765 |
Plan administrator’s name |
WILLIAM B. EVANS, M.D., S.C. |
Plan administrator’s
address |
3740 N. LAKE SHORE DRIVE, APT. 8A, CHICAGO, IL, 606134201 |
Administrator’s telephone number |
7738786000 |
Signature of
Role |
Plan administrator |
Date |
2013-07-08 |
Name of individual signing |
WILLIAM B. EVANS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM B. EVANS, M.D., S.C. EMPLOYEES' PENSION PLAN
|
2010
|
363161765
|
2012-07-13
|
WILLIAM B. EVANS, M.D., S.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7738786000
|
Plan sponsor’s
address |
3740 N. LAKE SHORE DRIVE, APT. 8A, CHICAGO, IL, 606134201
|
Plan administrator’s name and address
Administrator’s EIN |
363161765 |
Plan administrator’s name |
WILLIAM B. EVANS, M.D., S.C. |
Plan administrator’s
address |
3740 N. LAKE SHORE DRIVE, APT. 8A, CHICAGO, IL, 606134201 |
Administrator’s telephone number |
7738786000 |
Signature of
Role |
Plan administrator |
Date |
2012-07-13 |
Name of individual signing |
WILLIAM B. EVANS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WILLIAM B. EVANS, M.D., S.C. EMPLOYEES' PENSION PLAN
|
2009
|
363161765
|
2011-07-14
|
WILLIAM B. EVANS, M.D., S.C.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
7738786000
|
Plan sponsor’s
address |
3740 N. LAKE SHORE DRIVE, APT. 8A, CHICAGO, IL, 606134201
|
Plan administrator’s name and address
Administrator’s EIN |
363161765 |
Plan administrator’s name |
WILLIAM B. EVANS, M.D., S.C. |
Plan administrator’s
address |
3740 N. LAKE SHORE DRIVE, APT. 8A, CHICAGO, IL, 606134201 |
Administrator’s telephone number |
7738786000 |
Signature of
Role |
Plan administrator |
Date |
2011-07-14 |
Name of individual signing |
WILLIAM B. EVANS, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|