MODERT FAMILY PRACTICE 401(K) PLAN
|
2012
|
371379742
|
2013-07-17
|
MODERT FAMILY PRACTICE, LTD
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6182441234
|
Plan sponsor’s
address |
P.O. BOX 2280, 1708 JEFFERSON AVE., MT. VERNON, IL, 62864
|
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
SARA MODERT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MODERT FAMILY PRACTICE 401(K) PLAN
|
2011
|
371379742
|
2012-07-02
|
MODERT FAMILY PRACTICE, LTD
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6182441234
|
Plan sponsor’s
address |
P.O. BOX 2280, 1708 JEFFERSON AVE., MT. VERNON, IL, 62864
|
Plan administrator’s name and address
Administrator’s EIN |
371379742 |
Plan administrator’s name |
MODERT FAMILY PRACTICE, LTD |
Plan administrator’s
address |
P.O. BOX 2280, 1708 JEFFERSON AVE., MT. VERNON, IL, 62864 |
Administrator’s telephone number |
6182441234 |
Signature of
Role |
Plan administrator |
Date |
2012-07-02 |
Name of individual signing |
SARA MODERT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MODERT FAMILY PRACTICE 401(K) PLAN
|
2010
|
371379742
|
2011-07-20
|
MODERT FAMILY PRACTICE, LTD
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6182441234
|
Plan sponsor’s
address |
P.O. BOX 2280, 1708 JEFFERSON AVE., MT. VERNON, IL, 62864
|
Plan administrator’s name and address
Administrator’s EIN |
371379742 |
Plan administrator’s name |
MODERT FAMILY PRACTICE, LTD |
Plan administrator’s
address |
P.O. BOX 2280, 1708 JEFFERSON AVE., MT. VERNON, IL, 62864 |
Administrator’s telephone number |
6182441234 |
Signature of
Role |
Plan administrator |
Date |
2011-07-14 |
Name of individual signing |
SARA K MODERT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|