|
OSI FURNITURE LLC SALARIED RETIREMENT PLAN
|
2011
|
261405855
|
2012-07-17
|
OSI FURNITURE, LLC
|
51
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1990-06-12
|
| Business code |
332900
|
| Sponsor’s telephone number |
8478067200
|
| Plan sponsor’s
address |
1965 PRATT BLVD., ELK GROVE, IL, 60007
|
Plan administrator’s name and address
| Administrator’s EIN |
261405855 |
| Plan administrator’s name |
OSI FURNITURE, LLC |
| Plan administrator’s
address |
1965 PRATT BLVD., ELK GROVE, IL, 60007 |
| Administrator’s telephone number |
8478067200 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-17 |
| Name of individual signing |
JEANETTE LIPECKI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-07-17 |
| Name of individual signing |
VYTAS AMBUTAS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
OSI FURNITURE LLC SALARIED RETIREMENT PLAN
|
2010
|
261405855
|
2011-07-27
|
OSI FURNITURE, LLC
|
102
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
002
|
| Effective date of plan |
1990-06-12
|
| Business code |
332900
|
| Sponsor’s telephone number |
8478067200
|
| Plan sponsor’s
address |
1965 PRATT BLVD., ELK GROVE, IL, 60007
|
Plan administrator’s name and address
| Administrator’s EIN |
261405855 |
| Plan administrator’s name |
OSI FURNITURE, LLC |
| Plan administrator’s
address |
1965 PRATT BLVD., ELK GROVE, IL, 60007 |
| Administrator’s telephone number |
8478067200 |
Signature of
| Role |
Plan administrator |
| Date |
2011-07-27 |
| Name of individual signing |
JEANETTE LIPECKI |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-07-27 |
| Name of individual signing |
VYTAS AMBUTAS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
