MARK W. JACOB, D.D.S., P.C. PROFIT SHARING PLAN
|
2012
|
363997579
|
2013-09-23
|
MARK W. JACOB, D.D.S., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8475642180
|
Plan sponsor’s
address |
4119 DUNDEE ROAD, NORTHBROOK, IL, 600622129
|
Plan administrator’s name and address
Administrator’s EIN |
363997579 |
Plan administrator’s name |
MARK W. JACOB, D.D.S., P.C. |
Plan administrator’s
address |
4119 DUNDEE ROAD, NORTHBROOK, IL, 600622129 |
Administrator’s telephone number |
8475642180 |
Signature of
Role |
Plan administrator |
Date |
2013-09-23 |
Name of individual signing |
MARK JACOB, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MARK W. JACOB, D.D.S., P.C. PROFIT SHARING PLAN
|
2011
|
363997579
|
2012-10-01
|
MARK W. JACOB, D.D.S., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8475642180
|
Plan sponsor’s
address |
4119 DUNDEE ROAD, NORTHBROOK, IL, 600622129
|
Plan administrator’s name and address
Administrator’s EIN |
363997579 |
Plan administrator’s name |
MARK W. JACOB, D.D.S., P.C. |
Plan administrator’s
address |
4119 DUNDEE ROAD, NORTHBROOK, IL, 600622129 |
Administrator’s telephone number |
8475642180 |
Signature of
Role |
Plan administrator |
Date |
2012-10-01 |
Name of individual signing |
MARK JACOB, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MARK W. JACOB, D.D.S., P.C. PROFIT SHARING PLAN
|
2010
|
363997579
|
2011-10-14
|
MARK W. JACOB, D.D.S., P.C.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1995-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8475642180
|
Plan sponsor’s
address |
4119 DUNDEE ROAD, NORTHBROOK, IL, 600622129
|
Plan administrator’s name and address
Administrator’s EIN |
363997579 |
Plan administrator’s name |
MARK W. JACOB, D.D.S., P.C. |
Plan administrator’s
address |
4119 DUNDEE ROAD, NORTHBROOK, IL, 600622129 |
Administrator’s telephone number |
8475642180 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
MARK JACOB, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|