RUSSELL S. POLLINA, D.D.S., P.C. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2012
|
364423165
|
2013-09-03
|
RUSSELL S. POLLINA, D.D.S., P.C.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473922457
|
Plan sponsor’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379
|
Signature of
Role |
Plan administrator |
Date |
2013-09-03 |
Name of individual signing |
RUSSELL S. POLLINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RUSSELL S. POLLINA, D.D.S., P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2012
|
364423165
|
2013-08-30
|
RUSSELL S. POLLINA, D.D.S., P.C.
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-09-03
|
Business code |
621210
|
Sponsor’s telephone number |
8473922457
|
Plan sponsor’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379
|
Signature of
Role |
Plan administrator |
Date |
2013-08-30 |
Name of individual signing |
RUSSELL S. POLLINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RUSSELL S. POLLINA, D.D.S., P.C. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2011
|
364423165
|
2012-10-09
|
RUSSELL S. POLLINA, D.D.S., P.C.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473922457
|
Plan sponsor’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379
|
Plan administrator’s name and address
Administrator’s EIN |
364423165 |
Plan administrator’s name |
RUSSELL S. POLLINA, D.D.S., P.C. |
Plan administrator’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379 |
Administrator’s telephone number |
8473922457 |
Signature of
Role |
Plan administrator |
Date |
2012-10-09 |
Name of individual signing |
RUSSELL S. POLLINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RUSSELL S. POLLINA, D.D.S., P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2011
|
364423165
|
2012-10-09
|
RUSSELL S. POLLINA, D.D.S., P.C.
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-09-03
|
Business code |
621210
|
Sponsor’s telephone number |
8473922457
|
Plan sponsor’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379
|
Plan administrator’s name and address
Administrator’s EIN |
364423165 |
Plan administrator’s name |
RUSSELL S. POLLINA, D.D.S., P.C. |
Plan administrator’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379 |
Administrator’s telephone number |
8473922457 |
Signature of
Role |
Plan administrator |
Date |
2012-10-09 |
Name of individual signing |
RUSSELL S. POLLINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RUSSELL S. POLLINA, D.D.S., P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2010
|
364423165
|
2011-10-12
|
RUSSELL S. POLLINA, D.D.S., P.C.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-09-03
|
Business code |
621210
|
Sponsor’s telephone number |
8473922457
|
Plan sponsor’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379
|
Plan administrator’s name and address
Administrator’s EIN |
364423165 |
Plan administrator’s name |
RUSSELL S. POLLINA, D.D.S., P.C. |
Plan administrator’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379 |
Administrator’s telephone number |
8473922457 |
Signature of
Role |
Plan administrator |
Date |
2011-10-12 |
Name of individual signing |
RUSSELL S. POLLINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RUSSELL S. POLLINA, D.D.S., P.C. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2010
|
364423165
|
2011-10-12
|
RUSSELL S. POLLINA, D.D.S., P.C.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473922457
|
Plan sponsor’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379
|
Plan administrator’s name and address
Administrator’s EIN |
364423165 |
Plan administrator’s name |
RUSSELL S. POLLINA, D.D.S., P.C. |
Plan administrator’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379 |
Administrator’s telephone number |
8473922457 |
Signature of
Role |
Plan administrator |
Date |
2011-10-12 |
Name of individual signing |
RUSSELL S. POLLINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RUSSELL S. POLLINA, D.D.S., P.C. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2009
|
364423165
|
2010-10-07
|
RUSSELL S. POLLINA, D.D.S., P.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2006-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8473922457
|
Plan sponsor’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379
|
Plan administrator’s name and address
Administrator’s EIN |
364423165 |
Plan administrator’s name |
RUSSELL S. POLLINA, D.D.S., P.C. |
Plan administrator’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379 |
Administrator’s telephone number |
8473922457 |
Signature of
Role |
Plan administrator |
Date |
2010-10-07 |
Name of individual signing |
RUSSELL S. POLLINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RUSSELL S. POLLINA, D.D.S., P.C. 401(K) PROFIT SHARING PLAN AND TRUST
|
2009
|
364423165
|
2010-10-07
|
RUSSELL S. POLLINA, D.D.S., P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-09-03
|
Business code |
621210
|
Sponsor’s telephone number |
8473922457
|
Plan sponsor’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379
|
Plan administrator’s name and address
Administrator’s EIN |
364423165 |
Plan administrator’s name |
RUSSELL S. POLLINA, D.D.S., P.C. |
Plan administrator’s
address |
601 WEST CENTRAL, SUITE 4, MOUNT PROSPECT, IL, 600562379 |
Administrator’s telephone number |
8473922457 |
Signature of
Role |
Plan administrator |
Date |
2010-10-07 |
Name of individual signing |
RUSSELL S. POLLINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|