|
CAPITOL CHIROPRACTIC / H&I FITNESS, LTD. 401(K) PROFIT SHARING PLAN
|
2012
|
371392396
|
2013-04-19
|
CAPITOL CHIROMED, LTD.
|
65
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1989-01-01
|
| Business code |
621310
|
| Sponsor’s telephone number |
2175445446
|
| Plan sponsor’s
address |
3631 SOUTH 6TH ST. ROAD #A, SPRINGFIELD, IL, 62703
|
Signature of
| Role |
Plan administrator |
| Date |
2013-04-19 |
| Name of individual signing |
KATHY GOLD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CAPITOL CHIROPRACTIC / H&I FITNESS, LTD. 401(K) PROFIT SHARING PLAN
|
2011
|
371392396
|
2012-03-28
|
CAPITOL CHIROMED, LTD.
|
76
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1989-01-01
|
| Business code |
621310
|
| Sponsor’s telephone number |
2175445446
|
| Plan sponsor’s
address |
3631 SOUTH 6TH ST. ROAD #A, SPRINGFIELD, IL, 62703
|
Plan administrator’s name and address
| Administrator’s EIN |
371392396 |
| Plan administrator’s name |
CAPITOL CHIROMED, LTD. |
| Plan administrator’s
address |
3631 SOUTH 6TH ST. ROAD #A, SPRINGFIELD, IL, 62703 |
| Administrator’s telephone number |
2175445446 |
Signature of
| Role |
Plan administrator |
| Date |
2012-03-28 |
| Name of individual signing |
KATHY GOLD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CAPITOL CHIROPRACTIC / H&I FITNESS, LTD. 401(K) PROFIT SHARING PLAN
|
2010
|
371392396
|
2011-03-17
|
CAPITOL CHIROMED, LTD.
|
82
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1989-01-01
|
| Business code |
621310
|
| Sponsor’s telephone number |
2175445446
|
| Plan sponsor’s
address |
3631 SOUTH 6TH ST. ROAD #A, SPRINGFIELD, IL, 62703
|
Plan administrator’s name and address
| Administrator’s EIN |
371392396 |
| Plan administrator’s name |
CAPITOL CHIROMED, LTD. |
| Plan administrator’s
address |
3631 SOUTH 6TH ST. ROAD #A, SPRINGFIELD, IL, 62703 |
| Administrator’s telephone number |
2175445446 |
Signature of
| Role |
Plan administrator |
| Date |
2011-03-17 |
| Name of individual signing |
KEVIN IMHOFF |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CAPITOL CHIROPRACTIC / H&I FITNESS, LTD. 401(K) PROFIT SHARING PLAN
|
2009
|
371392396
|
2010-07-14
|
CAPITOL CHIROMED, LTD.
|
90
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1989-01-01
|
| Business code |
621310
|
| Sponsor’s telephone number |
2175445446
|
| Plan sponsor’s
address |
3631 SOUTH 6TH ST. ROAD #A, SPRINGFIELD, IL, 62703
|
Plan administrator’s name and address
| Administrator’s EIN |
371392396 |
| Plan administrator’s name |
CAPITOL CHIROMED, LTD. |
| Plan administrator’s
address |
3631 SOUTH 6TH ST. ROAD #A, SPRINGFIELD, IL, 62703 |
| Administrator’s telephone number |
2175445446 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-14 |
| Name of individual signing |
KEVIN IMHOFF |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
