ANN E. KINNEALEY M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2011
|
364407260
|
2012-07-17
|
ANN E. KINNEALEY, M.D., P.C.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-02
|
Business code |
621399
|
Sponsor’s telephone number |
7084796532
|
Plan sponsor’s
address |
9930 W 190TH ST STE L, MOKENA, IL, 604485610
|
Plan administrator’s name and address
Administrator’s EIN |
364407260 |
Plan administrator’s name |
ANN E. KINNEALEY, M.D., P.C. |
Plan administrator’s
address |
9930 W 190TH ST STE L, MOKENA, IL, 604485610 |
Administrator’s telephone number |
7084796532 |
Signature of
Role |
Plan administrator |
Date |
2012-07-17 |
Name of individual signing |
MICHAEL KOZIOL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-17 |
Name of individual signing |
MICHAEL KOZIOL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ANN E. KINNEALEY M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2010
|
364407260
|
2011-06-07
|
ANN E. KINNEALEY, M.D., P.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-02
|
Business code |
621399
|
Sponsor’s telephone number |
7084796532
|
Plan sponsor’s
address |
9930 W 190TH ST STE L, MOKENA, IL, 604485610
|
Plan administrator’s name and address
Administrator’s EIN |
364407260 |
Plan administrator’s name |
ANN E. KINNEALEY, M.D., P.C. |
Plan administrator’s
address |
9930 W 190TH ST STE L, MOKENA, IL, 604485610 |
Administrator’s telephone number |
7084796532 |
Signature of
Role |
Plan administrator |
Date |
2011-06-07 |
Name of individual signing |
MICHAEL KOZIOL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-06-07 |
Name of individual signing |
MICHAEL KOZIOL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ANN E. KINNEALEY M.D., P.C. 401(K) PROFIT SHARING PLAN
|
2009
|
364407260
|
2010-08-23
|
ANN E. KINNEALEY, M.D., P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2001-01-02
|
Business code |
621399
|
Sponsor’s telephone number |
7084796532
|
Plan sponsor’s
address |
9930 W 190TH ST STE L, MOKENA, IL, 604485610
|
Plan administrator’s name and address
Administrator’s EIN |
364407260 |
Plan administrator’s name |
ANN E. KINNEALEY, M.D., P.C. |
Plan administrator’s
address |
9930 W 190TH ST STE L, MOKENA, IL, 604485610 |
Administrator’s telephone number |
7084796532 |
Signature of
Role |
Plan administrator |
Date |
2010-08-23 |
Name of individual signing |
ANN E KINNEALEY MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-08-23 |
Name of individual signing |
ANN E KINNEALEY MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|