FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2018
|
371244632
|
2019-06-05
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62522
|
Signature of
Role |
Plan administrator |
Date |
2019-06-05 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-05 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2018
|
371244632
|
2019-09-09
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62522
|
Signature of
Role |
Plan administrator |
Date |
2019-09-09 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-09-09 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2017
|
371244632
|
2018-06-06
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62522
|
Signature of
Role |
Plan administrator |
Date |
2018-05-30 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-30 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2016
|
371244632
|
2017-07-24
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62522
|
Signature of
Role |
Plan administrator |
Date |
2017-07-07 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2015
|
371244632
|
2016-08-16
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62521
|
Signature of
Role |
Plan administrator |
Date |
2016-08-16 |
Name of individual signing |
SHELLY L. STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2014
|
371244632
|
2015-06-03
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62521
|
Signature of
Role |
Plan administrator |
Date |
2015-06-01 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-06-01 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2013
|
371244632
|
2014-07-14
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62521
|
Signature of
Role |
Plan administrator |
Date |
2014-07-14 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-14 |
Name of individual signing |
SHELLY STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2012
|
371244632
|
2013-06-18
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62521
|
Signature of
Role |
Plan administrator |
Date |
2013-06-18 |
Name of individual signing |
SHELLY L. STEVENS DVM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-18 |
Name of individual signing |
SHELLY L. STEVENS DVM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2011
|
371244632
|
2012-07-03
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62521
|
Plan administrator’s name and address
Administrator’s EIN |
371244632 |
Plan administrator’s name |
FAIRVIEW HOSPITAL FOR ANIMALS |
Plan administrator’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62521 |
Administrator’s telephone number |
2174287709 |
Signature of
Role |
Plan administrator |
Date |
2012-07-03 |
Name of individual signing |
SHELLY L. STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-03 |
Name of individual signing |
SHELLY L. STEVENS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FAIRVIEW HOSPITAL FOR ANIMALS PROFIT SHARING PLAN
|
2010
|
371244632
|
2011-07-05
|
FAIRVIEW HOSPITAL FOR ANIMALS
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1991-01-01
|
Business code |
541940
|
Sponsor’s telephone number |
2174287709
|
Plan sponsor’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62521
|
Plan administrator’s name and address
Administrator’s EIN |
371244632 |
Plan administrator’s name |
FAIRVIEW HOSPITAL FOR ANIMALS |
Plan administrator’s
address |
1090 W. SOUTH SIDE DR., DECATUR, IL, 62521 |
Administrator’s telephone number |
2174287709 |
Signature of
Role |
Plan administrator |
Date |
2011-07-05 |
Name of individual signing |
SHELLY L. STEVENS, DVM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-05 |
Name of individual signing |
SHELLY L. STEVENS, DVM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|