| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2006-01-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
8473290702
|
| Plan sponsor’s
address |
5340 LINCOLN AVE., SUITE 200, SKOKIE, IL, 60077
|
Plan administrator’s name and address
| Administrator’s EIN |
364162592 |
| Plan administrator’s name |
LIFE HOME HEALTH CARE, INC. |
| Plan administrator’s
address |
5340 LINCOLN AVE., SUITE 200, SKOKIE, IL, 60077 |
| Administrator’s telephone number |
8473290702 |
Signature of
| Role |
Plan administrator |
| Date |
2010-10-06 |
| Name of individual signing |
CECILIA BUENAFLOR |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-10-06 |
| Name of individual signing |
CECILIA BUENAFLOR |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
