DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST
|
2023
|
204569672
|
2024-06-26
|
DERICK DERMATOLOGY, PLLC
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2010-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123
|
Signature of
Role |
Plan administrator |
Date |
2024-06-26 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-06-26 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST
|
2022
|
204569672
|
2023-10-04
|
DERICK DERMATOLOGY, PLLC
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2010-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123
|
Signature of
Role |
Plan administrator |
Date |
2023-10-04 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-10-04 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST
|
2021
|
204569672
|
2022-09-30
|
DERICK DERMATOLOGY, PLLC
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2010-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123
|
Signature of
Role |
Plan administrator |
Date |
2022-09-30 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-09-30 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST
|
2020
|
204569672
|
2021-07-19
|
DERICK DERMATOLOGY, LLC
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2010-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123
|
Signature of
Role |
Plan administrator |
Date |
2021-07-19 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-07-19 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST
|
2019
|
204569672
|
2020-08-03
|
DERICK DERMATOLOGY, LLC
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2010-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1600 N RANDALL ROAD SUITE 400, ELGIN, IL, 60123
|
Signature of
Role |
Plan administrator |
Date |
2020-08-03 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-08-03 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST
|
2018
|
204569672
|
2019-08-12
|
DERICK DERMATOLOGY, LLC
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2010-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1531 SOUTH GROVE AVENUE, SUITE 101, BARRINGTON, IL, 60010
|
Signature of
Role |
Plan administrator |
Date |
2019-08-10 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-08-10 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERICK DERMATOLOGY LLC 401(K) PLAN
|
2017
|
204569672
|
2018-05-30
|
DERICK DERMATOLOGY LLC
|
91
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1531 S GROVE AVE SUITE 101, BARRINGTON, IL, 60010
|
Signature of
Role |
Plan administrator |
Date |
2018-05-30 |
Name of individual signing |
KAELYN TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST
|
2017
|
204569672
|
2018-10-01
|
DERICK DERMATOLOGY, LLC
|
26
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2010-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1531 SOUTH GROVE AVENUE, SUITE 101, BARRINGTON, IL, 60010
|
Signature of
Role |
Plan administrator |
Date |
2018-09-27 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-09-27 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERICK DERMATOLOGY LLC 401(K) PLAN
|
2016
|
204569672
|
2017-07-06
|
DERICK DERMATOLOGY LLC
|
111
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2009-02-01
|
Business code |
621111
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1531 S GROVE AVE SUITE 101, BARRINGTON, IL, 60010
|
Signature of
Role |
Plan administrator |
Date |
2017-07-06 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DERICK DERMATOLOGY, LLC CASH BALANCE PENSION PLAN & TRUST
|
2016
|
204569672
|
2017-09-25
|
DERICK DERMATOLOGY, LLC
|
27
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2010-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
8473818899
|
Plan sponsor’s
address |
1531 SOUTH GROVE AVENUE, SUITE 101, SUITE 101, BARRINGTON, IL, 60010
|
Signature of
Role |
Plan administrator |
Date |
2017-09-25 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-09-25 |
Name of individual signing |
MICHAEL DERICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|