PATRICIA M. BOATWRIGHT, M.D., P.C. PROFIT SHARING PLAN AND TRUST
|
2019
|
363632106
|
2020-10-13
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 WEST HARRISON STREET, SUITE 351, CHICAGO, IL, 60612
|
Signature of
Role |
Plan administrator |
Date |
2020-10-13 |
Name of individual signing |
KENDRA DICKENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-10-13 |
Name of individual signing |
KENDRA DICKENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
2018
|
363632106
|
2019-12-30
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 WEST HARRISON STREET, SUITE 351, CHICAGO, IL, 60612
|
Signature of
Role |
Plan administrator |
Date |
2019-12-30 |
Name of individual signing |
PATRICIA M BOATWRIGHT |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-12-30 |
Name of individual signing |
PATRICIA M BOATWRIGHT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PATRICIA M. BOATWRIGHT, M.D., P.C. PROFIT SHARING PLAN AND TRUST
|
2017
|
363632106
|
2018-06-28
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852
|
Signature of
Role |
Plan administrator |
Date |
2018-06-27 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-27 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PATRICIA M. BOATWRIGHT, M.D., P.C. PROFIT SHARING PLAN AND TRUST
|
2016
|
363632106
|
2017-10-11
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852
|
Signature of
Role |
Plan administrator |
Date |
2017-10-11 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-10-11 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PATRICIA M. BOATWRIGHT, M.D., P.C. PROFIT SHARING PLAN AND TRUST
|
2015
|
363632106
|
2016-10-09
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852
|
Signature of
Role |
Plan administrator |
Date |
2016-10-07 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-07 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PATRICIA M. BOATWRIGHT, M.D., P.C. PROFIT SHARING PLAN AND TRUST
|
2014
|
363632106
|
2015-10-13
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852
|
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PATRICIA M. BOATWRIGHT, M.D., P.C. PROFIT SHARING PLAN AND TRUST
|
2013
|
363632106
|
2014-08-19
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852
|
Signature of
Role |
Plan administrator |
Date |
2014-08-19 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-08-19 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PATRICIA M. BOATWRIGHT, M.D., P.C. PROFIT SHARING PLAN AND TRUST
|
2012
|
363632106
|
2013-09-26
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852
|
Signature of
Role |
Plan administrator |
Date |
2013-09-26 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-09-26 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PATRICIA M. BOATWRIGHT, M.D., P.C. PROFIT SHARING PLAN AND TRUST
|
2011
|
363632106
|
2012-10-12
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852
|
Plan administrator’s name and address
Administrator’s EIN |
363632106 |
Plan administrator’s name |
PATRICIA M. BOATWRIGHT, M.D., P.C. |
Plan administrator’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852 |
Administrator’s telephone number |
3127380055 |
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-11 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PATRICIA M. BOATWRIGHT, M.D., P.C. PROFIT SHARING PLAN AND TRUST
|
2010
|
363632106
|
2011-10-10
|
PATRICIA M. BOATWRIGHT, M.D., P.C.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1989-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
3127380055
|
Plan sponsor’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852
|
Plan administrator’s name and address
Administrator’s EIN |
363632106 |
Plan administrator’s name |
PATRICIA M. BOATWRIGHT, M.D., P.C. |
Plan administrator’s
address |
1725 W. HARRISON ST., CHICAGO, IL, 606123852 |
Administrator’s telephone number |
3127380055 |
Signature of
Role |
Plan administrator |
Date |
2011-10-10 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-10-10 |
Name of individual signing |
PATRICIA M. BOATWRIGHT, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|