PRAIRIE ORTHODONTICS, P.C. RETIREMENT TRUST
|
2012
|
364029844
|
2013-07-05
|
PRAIRIE ORTHODONTICS, P.C.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
8472498800
|
Plan sponsor’s
address |
6121 WASHINGTON ST., SUITE 204, CURNEE, IL, 60031
|
Signature of
Role |
Plan administrator |
Date |
2013-07-05 |
Name of individual signing |
MICHAEL WEINBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-05 |
Name of individual signing |
MICHAEL WEINBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAIRIE ORTHODONTICS, P.C. RETIREMENT TRUST
|
2011
|
364029844
|
2012-08-31
|
PRAIRIE ORTHODONTICS, P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
8472498800
|
Plan sponsor’s
address |
6121 WASHINGTON ST., SUITE 204, CURNEE, IL, 60031
|
Plan administrator’s name and address
Administrator’s EIN |
364029844 |
Plan administrator’s name |
PRAIRIE ORTHODONTICS, P.C. |
Plan administrator’s
address |
6121 WASHINGTON ST., SUITE 204, CURNEE, IL, 60031 |
Administrator’s telephone number |
8472498800 |
Signature of
Role |
Plan administrator |
Date |
2012-08-31 |
Name of individual signing |
MICHAEL WEINBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAIRIE ORTHODONTICS, P.C. RETIREMENT TRUST
|
2010
|
364029844
|
2011-06-30
|
PRAIRIE ORTHODONTICS, P.C.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
8472498800
|
Plan sponsor’s
address |
6121 WASHINGTON ST., SUITE 204, GURNEE, IL, 60031
|
Plan administrator’s name and address
Administrator’s EIN |
364029844 |
Plan administrator’s name |
PRAIRIE ORTHODONTICS, P.C. |
Plan administrator’s
address |
6121 WASHINGTON ST., SUITE 204, GURNEE, IL, 60031 |
Administrator’s telephone number |
8472498800 |
Signature of
Role |
Plan administrator |
Date |
2011-06-30 |
Name of individual signing |
MICHAEL WEINBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-06-30 |
Name of individual signing |
MICHAEL WEINBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAIRIE ORTHODONTICS, P.C. RETIREMENT TRUST
|
2009
|
364029844
|
2010-07-21
|
PRAIRIE ORTHODONTICS, P.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
8472498800
|
Plan sponsor’s
address |
6121 WASHINGTON ST., SUITE 204, GURNEE, IL, 60031
|
Plan administrator’s name and address
Administrator’s EIN |
364029844 |
Plan administrator’s name |
PRAIRIE ORTHODONTICS, P.C. |
Plan administrator’s
address |
6121 WASHINGTON ST., SUITE 204, GURNEE, IL, 60031 |
Administrator’s telephone number |
8472498800 |
Signature of
Role |
Plan administrator |
Date |
2010-07-21 |
Name of individual signing |
MICHAEL WEINBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-21 |
Name of individual signing |
MICHAEL WEINBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRAIRIE ORTHODONTICS, P.C. RETIREMENT TRUST
|
2009
|
364029844
|
2010-07-21
|
PRAIRIE ORTHODONTICS, P.C.
|
11
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
8472498800
|
Plan sponsor’s
address |
6121 WASHINGTON ST., SUITE 204, GURNEE, IL, 60031
|
Plan administrator’s name and address
Administrator’s EIN |
364029844 |
Plan administrator’s name |
PRAIRIE ORTHODONTICS, P.C. |
Plan administrator’s
address |
6121 WASHINGTON ST., SUITE 204, GURNEE, IL, 60031 |
Administrator’s telephone number |
8472498800 |
Signature of
Role |
Plan administrator |
Date |
2010-07-21 |
Name of individual signing |
MICHAEL WEINBERG |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-21 |
Name of individual signing |
MICHAEL WEINBERG |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|