HILLCREST GOLF CENTER INC. PROFIT SHARING PLAN
|
2016
|
562401348
|
2017-07-25
|
HILLCREST GOLF CENTER INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
3092568565
|
Plan sponsor’s
address |
816 SIMON ST, WASHINGTON, IL, 615719276
|
Plan administrator’s name and address
Administrator’s EIN |
562401348 |
Plan administrator’s name |
BRIAN K BRUBAKER |
Plan administrator’s
address |
816 SIMON ST, WASHINGTON, IL, 615719276 |
Administrator’s telephone number |
3092568565 |
Signature of
Role |
Plan administrator |
Date |
2017-07-20 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HILLCREST GOLF CENTER INC. PROFIT SHARING PLAN
|
2015
|
562401348
|
2016-07-20
|
HILLCREST GOLF CENTER INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
3092568565
|
Plan sponsor’s
address |
816 SIMON ST, WASHINGTON, IL, 615719276
|
Plan administrator’s name and address
Administrator’s EIN |
562401348 |
Plan administrator’s name |
BRIAN K. BRUBAKER |
Plan administrator’s
address |
816 SIMON ST, WASHINGTON, IL, 615719276 |
Administrator’s telephone number |
3092568565 |
Signature of
Role |
Plan administrator |
Date |
2016-07-20 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-20 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HILLCREST GOLF CENTER INC. PROFIT SHARING PLAN
|
2014
|
562401348
|
2015-07-16
|
HILLCREST GOLF CENTER INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
3092568565
|
Plan sponsor’s
address |
816 SIMON, WASHINGTON, IL, 61571
|
Plan administrator’s name and address
Administrator’s EIN |
562401348 |
Plan administrator’s name |
BRIAN K. BRUBAKER |
Plan administrator’s
address |
816 SIMON, WASHINGTON, IL, 61571 |
Administrator’s telephone number |
3092568565 |
Signature of
Role |
Plan administrator |
Date |
2015-07-16 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-16 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HILLCREST GOLF CENTER INC. PROFIT SHARING PLAN
|
2013
|
562401348
|
2014-07-02
|
HILLCREST GOLF CENTER INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
3092568565
|
Plan sponsor’s
address |
816 SIMON, WASHINGTON, IL, 61571
|
Plan administrator’s name and address
Administrator’s EIN |
562401348 |
Plan administrator’s name |
BRIAN K BRUBAKER |
Administrator’s telephone number |
3092568565 |
Signature of
Role |
Plan administrator |
Date |
2014-07-02 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HILLCREST GOLF CENTER INC PROFIT SHARING PLAN
|
2012
|
562401348
|
2014-07-17
|
HILLCREST GOLF CENTER INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
3092568565
|
Plan sponsor’s
address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571
|
Plan administrator’s name and address
Administrator’s EIN |
562401348 |
Plan administrator’s name |
BRIAN K BRUBAKER |
Administrator’s telephone number |
3092568565 |
Signature of
Role |
Plan administrator |
Date |
2014-07-16 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HILLCREST GOLF CENTER INC PROFIT SHARING PLAN
|
2012
|
562401348
|
2013-06-27
|
HILLCREST GOLF CENTER INC
|
2
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
3094449033
|
Plan sponsor’s
address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571
|
Plan administrator’s name and address
Administrator’s EIN |
562401348 |
Plan administrator’s name |
BRIAN K BRUBAKER |
Administrator’s telephone number |
3094449033 |
Signature of
Role |
Plan administrator |
Date |
2013-06-27 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-27 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HILLCREST GOLF CENTER INC PROFIT SHARING PLAN
|
2011
|
562401348
|
2012-06-26
|
HILLCREST GOLF CENTER INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
3094449033
|
Plan sponsor’s mailing address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571
|
Plan sponsor’s
address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571
|
Plan administrator’s name and address
Administrator’s EIN |
562401348 |
Plan administrator’s name |
BRIAN K BRUBAKER |
Plan administrator’s
address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571 |
Administrator’s telephone number |
3094449033 |
Number of participants as of the end of the plan year
Active participants |
2 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
2 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-06-26 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HILLCREST GOLF CENTER INC PROFIT SHARING PLAN
|
2010
|
562401348
|
2011-07-05
|
HILLCREST GOLF CENTER INC
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
3094449033
|
Plan sponsor’s mailing address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571
|
Plan sponsor’s
address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571
|
Plan administrator’s name and address
Administrator’s EIN |
562401348 |
Plan administrator’s name |
BRIAN K BRUBAKER |
Plan administrator’s
address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571 |
Administrator’s telephone number |
3094449033 |
Number of participants as of the end of the plan year
Active participants |
2 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
2 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-02 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HILLCREST GOLF CENTER INC PROFIT SHARING PLAN
|
2009
|
562401348
|
2010-06-15
|
HILLCREST GOLF CENTER INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2004-01-01
|
Business code |
713900
|
Sponsor’s telephone number |
3094449033
|
Plan sponsor’s mailing address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571
|
Plan sponsor’s
address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571
|
Plan administrator’s name and address
Administrator’s EIN |
562401348 |
Plan administrator’s name |
BRIAN K. BRUBAKER |
Plan administrator’s
address |
1829 WASHINGTON ROAD, WASHINGTON, IL, 61571 |
Administrator’s telephone number |
3094449033 |
Number of participants as of the end of the plan year
Active participants |
2 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
2 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-06-15 |
Name of individual signing |
BRIAN BRUBAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|