JAC STORES, INC. 401(K) PLAN
|
2012
|
371113611
|
2013-02-06
|
JAC STORES, INC.
|
87
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
2173626226
|
Plan sponsor’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367
|
Signature of
Role |
Plan administrator |
Date |
2013-02-06 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-02-06 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAC STORES, INC. 401(K) PLAN
|
2011
|
371113611
|
2012-04-25
|
JAC STORES, INC.
|
71
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
2173626226
|
Plan sponsor’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367
|
Plan administrator’s name and address
Administrator’s EIN |
371113611 |
Plan administrator’s name |
JAC STORES, INC. |
Plan administrator’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367 |
Administrator’s telephone number |
2173626226 |
Signature of
Role |
Plan administrator |
Date |
2012-04-25 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-04-25 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAC STORES, INC. 401(K) PLAN
|
2010
|
371113611
|
2011-09-23
|
JAC STORES, INC.
|
72
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
2173626226
|
Plan sponsor’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367
|
Plan administrator’s name and address
Administrator’s EIN |
371113611 |
Plan administrator’s name |
JAC STORES, INC. |
Plan administrator’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367 |
Administrator’s telephone number |
2173626226 |
Signature of
Role |
Plan administrator |
Date |
2011-09-23 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-09-23 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
JAC STORES, INC. 401(K) PLAN
|
2010
|
371113611
|
2011-07-18
|
JAC STORES, INC.
|
72
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
2173626226
|
Plan sponsor’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367
|
Plan administrator’s name and address
Administrator’s EIN |
371113611 |
Plan administrator’s name |
JAC STORES, INC. |
Plan administrator’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367 |
Administrator’s telephone number |
2173626226 |
Signature of
Role |
Plan administrator |
Date |
2011-07-18 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-18 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
JAC STORES, INC. 401(K) PLAN
|
2010
|
371113611
|
2012-04-25
|
JAC STORES, INC.
|
72
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
2173626226
|
Plan sponsor’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367
|
Plan administrator’s name and address
Administrator’s EIN |
371113611 |
Plan administrator’s name |
JAC STORES, INC. |
Plan administrator’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367 |
Administrator’s telephone number |
2173626226 |
Signature of
Role |
Plan administrator |
Date |
2012-04-25 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAC STORES, INC. 401(K) PLAN
|
2010
|
371113611
|
2011-09-26
|
JAC STORES, INC.
|
72
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
2173626226
|
Plan sponsor’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367
|
Plan administrator’s name and address
Administrator’s EIN |
371113611 |
Plan administrator’s name |
JAC STORES, INC. |
Plan administrator’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367 |
Administrator’s telephone number |
2173626226 |
Signature of
Role |
Plan administrator |
Date |
2011-09-26 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-09-26 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JAC STORES, INC. 401(K) PLAN
|
2009
|
371113611
|
2010-04-29
|
JAC STORES, INC.
|
71
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-11-01
|
Business code |
446110
|
Sponsor’s telephone number |
2173626226
|
Plan sponsor’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367
|
Plan administrator’s name and address
Administrator’s EIN |
371113611 |
Plan administrator’s name |
JAC STORES, INC. |
Plan administrator’s
address |
2245 W MOUND RD, DECATUR, IL, 625269367 |
Administrator’s telephone number |
2173626226 |
Signature of
Role |
Plan administrator |
Date |
2010-04-27 |
Name of individual signing |
DAVID FALK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-04-29 |
Name of individual signing |
DAVID E. FALK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|