BALUCHI MEDICAL GROUP, CASH OR DEFERRED PROFIT SHARING PLAN
|
2011
|
363051380
|
2013-08-05
|
BALUCHI MEDICAL GROUP, LTD.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
6304957000
|
Plan sponsor’s
address |
1 S. 161 SUMMIT, OAK BROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
363051380 |
Plan administrator’s name |
BALUCHI MEDICAL GROUP, LTD. |
Plan administrator’s
address |
1 S. 161 SUMMIT, OAK BROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6304957000 |
Signature of
Role |
Plan administrator |
Date |
2013-08-05 |
Name of individual signing |
PAUL BOGOSLAW |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-08-05 |
Name of individual signing |
PAUL BOGOSLAW |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BALUCHI MEDICAL GROUP, LTD.
|
2010
|
363051380
|
2012-09-14
|
BALUCHI MEDICAL GROUP, LTD.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
6304957000
|
Plan sponsor’s
address |
1 S. 161 SUMMIT, OAK BROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
363051380 |
Plan administrator’s name |
BALUCHI MEDICAL GROUP, LTD. |
Plan administrator’s
address |
1 S. 161 SUMMIT, OAK BROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6304957000 |
Signature of
Role |
Plan administrator |
Date |
2012-09-14 |
Name of individual signing |
PAUL H. BOGOSLAW |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-09-14 |
Name of individual signing |
PAUL H. BOGOSLAW |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BALUCHI MEDICAL GROUP, LTD. 401K PSP & TRUST
|
2009
|
363051380
|
2011-08-29
|
BALUCHI MEDICAL GROUP, LTD.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1992-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
6304957000
|
Plan sponsor’s
address |
1 S. 161 SUMMIT, OAK BROOK TERRACE, IL, 60181
|
Plan administrator’s name and address
Administrator’s EIN |
363051380 |
Plan administrator’s name |
BALUCHI MEDICAL GROUP, LTD. |
Plan administrator’s
address |
1 S. 161 SUMMIT, OAK BROOK TERRACE, IL, 60181 |
Administrator’s telephone number |
6304957000 |
Signature of
Role |
Plan administrator |
Date |
2011-08-29 |
Name of individual signing |
AMJAD Z. KHAN, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-08-29 |
Name of individual signing |
AMJAD Z. KHAN, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|