| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1995-01-01
|
| Business code |
541940
|
| Sponsor’s telephone number |
6307732040
|
| Plan sponsor’s
address |
220 CATALPA AVENUE, ITASCA, IL, 601432028
|
Plan administrator’s name and address
| Administrator’s EIN |
363763808 |
| Plan administrator’s name |
DEEKE ANIMAL HOSPITAL, LLC |
| Plan administrator’s
address |
220 CATALPA AVENUE, ITASCA, IL, 601432028 |
| Administrator’s telephone number |
6307732040 |
Signature of
| Role |
Plan administrator |
| Date |
2012-10-09 |
| Name of individual signing |
STEVEN R. SHAMBORA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-10-09 |
| Name of individual signing |
STEVEN R. SHAMBORA |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
