DEMOULIN BROTHERS & COMPANY HEALTH PLAN
|
2013
|
370244250
|
2014-07-30
|
DEMOULIN BROTHERS & COMPANY
|
152
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2000-01-01
|
Business code |
315280
|
Sponsor’s telephone number |
6186642000
|
Plan sponsor’s mailing address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Plan sponsor’s
address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-30 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DEMOULIN BROTHERS & COMPANY DENTAL, LIFE & VISION
|
2013
|
370244250
|
2014-07-30
|
DEMOULIN BROTHERS & COMPANY
|
186
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2005-01-01
|
Business code |
315280
|
Sponsor’s telephone number |
6186642000
|
Plan sponsor’s mailing address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Plan sponsor’s
address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-30 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DEMOULIN BROTHERS & COMPANY DENTAL, LIFE & VISION
|
2012
|
370244250
|
2013-07-18
|
DEMOULIN BROTHERS & COMPANY
|
182
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2005-01-01
|
Business code |
315290
|
Sponsor’s telephone number |
6186642000
|
Plan sponsor’s mailing address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Plan sponsor’s
address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-18 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-18 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DEMOULIN BROTHERS & COMPANY HEALTH PLAN
|
2012
|
370244250
|
2013-07-18
|
DEMOULIN BROTHERS & COMPANY
|
163
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2000-01-01
|
Business code |
315290
|
Sponsor’s telephone number |
6186642000
|
Plan sponsor’s mailing address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Plan sponsor’s
address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-18 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-18 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
J.S. PALUCH 401K PR PLAN
|
2012
|
362041116
|
2013-05-15
|
J.S. PALUCH CO., INC.
|
16
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2009-08-01
|
Business code |
511190
|
Sponsor’s telephone number |
8472332730
|
Plan sponsor’s
address |
PO BOX 2703, SCHILLER PARK, IL, 60131
|
Signature of
Role |
Plan administrator |
Date |
2013-05-15 |
Name of individual signing |
KATHIE THOMAS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DEMOULIN BROTHERS & COMPANY HEALTH PLAN
|
2011
|
370244250
|
2012-07-23
|
DEMOULIN BROTHERS & COMPANY
|
175
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2000-01-01
|
Business code |
315290
|
Sponsor’s telephone number |
6186642000
|
Plan sponsor’s mailing address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Plan sponsor’s
address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Plan administrator’s name and address
Administrator’s EIN |
370244250 |
Plan administrator’s name |
DEMOULIN BROTHERS & COMPANY |
Plan administrator’s
address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246 |
Administrator’s telephone number |
6186642000 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-23 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-23 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DEMOULIN BROTHERS & COMPANY DENTAL, LIFE & VISION
|
2011
|
370244250
|
2012-07-23
|
DEMOULIN BROTHERS & COMPANY
|
194
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2005-01-01
|
Business code |
315290
|
Sponsor’s telephone number |
6186642000
|
Plan sponsor’s mailing address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Plan sponsor’s
address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246
|
Plan administrator’s name and address
Administrator’s EIN |
370244250 |
Plan administrator’s name |
DEMOULIN BROTHERS & COMPANY |
Plan administrator’s
address |
1025 S. FOURTH STREET, GREENVILLE, IL, 62246 |
Administrator’s telephone number |
6186642000 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-23 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-23 |
Name of individual signing |
ROSEMARY YORK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
J.S. PALUCH 401K PR PLAN
|
2011
|
362041116
|
2012-06-08
|
J.S. PALUCH CO., INC.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2009-08-01
|
Business code |
511190
|
Sponsor’s telephone number |
8472332730
|
Plan sponsor’s
address |
PO BOX 2703, SCHILLER PARK, IL, 60131
|
Plan administrator’s name and address
Administrator’s EIN |
362041116 |
Plan administrator’s name |
J.S. PALUCH CO., INC. |
Plan administrator’s
address |
PO BOX 2703, SCHILLER PARK, IL, 60131 |
Administrator’s telephone number |
8472332730 |
Signature of
Role |
Plan administrator |
Date |
2012-06-08 |
Name of individual signing |
LINDA KAUP |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-06-08 |
Name of individual signing |
LINDA KAUP |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
J.S. PALUCH 401K PR PLAN
|
2011
|
362041116
|
2012-06-06
|
J.S. PALUCH CO., INC.
|
14
|
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2009-08-01
|
Business code |
511190
|
Sponsor’s telephone number |
8472332730
|
Plan sponsor’s
address |
PO BOX 2703, SCHILLER PARK, IL, 60131
|
Plan administrator’s name and address
Administrator’s EIN |
362041116 |
Plan administrator’s name |
J.S. PALUCH CO., INC. |
Plan administrator’s
address |
PO BOX 2703, SCHILLER PARK, IL, 60131 |
Administrator’s telephone number |
8472332730 |
Signature of
Role |
Plan administrator |
Date |
2012-06-06 |
Name of individual signing |
LINDA KAUP |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-06-06 |
Name of individual signing |
LINDA KAUP |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
J.S. PALUCH 401K PR PLAN
|
2011
|
362041116
|
2012-06-06
|
J.S. PALUCH CO., INC.
|
14
|
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2009-08-01
|
Business code |
511190
|
Sponsor’s telephone number |
8472332730
|
Plan sponsor’s
address |
PO BOX 2703, SCHILLER PARK, IL, 60131
|
Plan administrator’s name and address
Administrator’s EIN |
362041116 |
Plan administrator’s name |
J.S. PALUCH CO., INC. |
Plan administrator’s
address |
PO BOX 2703, SCHILLER PARK, IL, 60131 |
Administrator’s telephone number |
8472332730 |
Signature of
Role |
Plan administrator |
Date |
2012-06-06 |
Name of individual signing |
LINDA KAUP |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-06-06 |
Name of individual signing |
LINDA KAUP |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|