| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
523900
|
| Sponsor’s telephone number |
2173519000
|
| Plan sponsor’s
address |
4907 PEIFER LANE, CHAMPAIGN, IL, 61822
|
Plan administrator’s name and address
| Administrator’s EIN |
208167991 |
| Plan administrator’s name |
KIRBY DORNER INC |
| Plan administrator’s
address |
4907 PEIFER LANE, CHAMPAIGN, IL, 61822 |
| Administrator’s telephone number |
2173519000 |
Signature of
| Role |
Plan administrator |
| Date |
2010-05-03 |
| Name of individual signing |
JUSTIN KIRBY OR KURT DORNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-05-03 |
| Name of individual signing |
JUSTIN KIRBY OR KURT DORNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
