SCOTT L. ROSEN, M.D., LTD. EMPLOYEES' PROFIT SHARING PLAN AND TRUST
|
2012
|
364396691
|
2013-04-29
|
SCOTT L. ROSEN, M.D., LTD.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8474417610
|
Plan sponsor’s
address |
1343 HACKBERRY LANE, WINNETKA, IL, 600931607
|
Signature of
Role |
Plan administrator |
Date |
2013-04-29 |
Name of individual signing |
SCOTT L. ROSEN, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SCOTT L. ROSEN, M.D., LTD. CASH BALANCE PLAN AND TRUST
|
2011
|
364396691
|
2012-09-24
|
SCOTT L. ROSEN, M.D., LTD.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2009-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8477249400
|
Plan sponsor’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647
|
Plan administrator’s name and address
Administrator’s EIN |
364396691 |
Plan administrator’s name |
SCOTT L. ROSEN, M.D., LTD. |
Plan administrator’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647 |
Administrator’s telephone number |
8477249400 |
Signature of
Role |
Plan administrator |
Date |
2012-09-24 |
Name of individual signing |
SCOTT L. ROSEN, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SCOTT L. ROSEN, M.D., LTD. EMPLOYEES' PROFIT SHARING PLAN AND TRUST
|
2011
|
364396691
|
2012-09-24
|
SCOTT L. ROSEN, M.D., LTD.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8477249400
|
Plan sponsor’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647
|
Plan administrator’s name and address
Administrator’s EIN |
364396691 |
Plan administrator’s name |
SCOTT L. ROSEN, M.D., LTD. |
Plan administrator’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647 |
Administrator’s telephone number |
8477249400 |
Signature of
Role |
Plan administrator |
Date |
2012-09-24 |
Name of individual signing |
SCOTT L. ROSEN, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SCOTT L. ROSEN, M.D., LTD. CASH BALANCE PLAN AND TRUST
|
2010
|
364396691
|
2011-10-05
|
SCOTT L. ROSEN, M.D., LTD.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2009-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8477249400
|
Plan sponsor’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647
|
Plan administrator’s name and address
Administrator’s EIN |
364396691 |
Plan administrator’s name |
SCOTT L. ROSEN, M.D., LTD. |
Plan administrator’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647 |
Administrator’s telephone number |
8477249400 |
Signature of
Role |
Plan administrator |
Date |
2011-10-05 |
Name of individual signing |
SCOTT L. ROSEN, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SCOTT L. ROSEN, M.D., LTD. EMPLOYEES' PROFIT SHARING PLAN AND TRUST
|
2010
|
364396691
|
2011-10-05
|
SCOTT L. ROSEN, M.D., LTD.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8477249400
|
Plan sponsor’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647
|
Plan administrator’s name and address
Administrator’s EIN |
364396691 |
Plan administrator’s name |
SCOTT L. ROSEN, M.D., LTD. |
Plan administrator’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647 |
Administrator’s telephone number |
8477249400 |
Signature of
Role |
Plan administrator |
Date |
2011-10-05 |
Name of individual signing |
SCOTT L. ROSEN, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SCOTT L. ROSEN, M.D., LTD. EMPLOYEES' PROFIT SHARING PLAN AND TRUST
|
2009
|
364396691
|
2010-10-07
|
SCOTT L. ROSEN, M.D., LTD.
|
0
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8477249400
|
Plan sponsor’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647
|
Plan administrator’s name and address
Administrator’s EIN |
364396691 |
Plan administrator’s name |
SCOTT L. ROSEN, M.D., LTD. |
Plan administrator’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647 |
Administrator’s telephone number |
8477249400 |
Signature of
Role |
Plan administrator |
Date |
2010-10-06 |
Name of individual signing |
SCOTT L. ROSEN, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SCOTT L. ROSEN, M.D., LTD. CASH BALANCE PLAN AND TRUST
|
2009
|
364396691
|
2010-09-15
|
SCOTT L. ROSEN, M.D., LTD.
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2009-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
8477249400
|
Plan sponsor’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647
|
Plan administrator’s name and address
Administrator’s EIN |
364396691 |
Plan administrator’s name |
SCOTT L. ROSEN, M.D., LTD. |
Plan administrator’s
address |
2440 RAVINE WAY, STE. 500, GLENVIEW, IL, 600257647 |
Administrator’s telephone number |
8477249400 |
Signature of
Role |
Plan administrator |
Date |
2010-09-14 |
Name of individual signing |
SCOTT L. ROSEN, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|