BLACK BROTHERS COMPANY SHOP EMPLOYEES PENSION PLAN
|
2019
|
360810680
|
2020-01-22
|
BLACK BROS. CO.
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1960-07-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410
|
Signature of
Role |
Plan administrator |
Date |
2020-01-22 |
Name of individual signing |
MEGAN KNEEBONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-01-22 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK BROTHERS COMPANY SHOP EMPLOYEES PENSION PLAN
|
2018
|
360810680
|
2020-01-21
|
BLACK BROS. CO.
|
38
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1960-07-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410
|
Signature of
Role |
Plan administrator |
Date |
2020-01-21 |
Name of individual signing |
MEGAN KNEEBONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-01-21 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK BROTHERS COMPANY SHOP EMPLOYEES PENSION PLAN
|
2017
|
360810680
|
2019-01-22
|
BLACK BROS. CO.
|
38
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1960-07-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410
|
Signature of
Role |
Plan administrator |
Date |
2019-01-22 |
Name of individual signing |
MEGAN KNEEBONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-01-22 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK BROTHERS COMPANY SHOP EMPLOYEES PENSION PLAN
|
2016
|
360810680
|
2018-01-03
|
BLACK BROS. CO.
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1960-07-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410
|
Signature of
Role |
Plan administrator |
Date |
2018-01-03 |
Name of individual signing |
MEGAN KNEEBONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-01-03 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK BROTHERS COMPANY SHOP EMPLOYEES PENSION PLAN
|
2015
|
360810680
|
2017-01-04
|
BLACK BROS. CO.
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1960-07-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410
|
Signature of
Role |
Plan administrator |
Date |
2017-01-04 |
Name of individual signing |
MEGAN KNEEBONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-01-04 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK BROTHERS COMPANY SHOP EMPLOYEES PENSION PLAN
|
2014
|
360810680
|
2016-01-20
|
BLACK BROS. CO.
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1960-07-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410
|
Signature of
Role |
Plan administrator |
Date |
2016-01-20 |
Name of individual signing |
MEGAN KNEEBONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-01-20 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK BROTHERS COMPANY SHOP EMPLOYEES PENSION PLAN
|
2013
|
360810680
|
2015-01-19
|
BLACK BROS. CO.
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1960-07-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410
|
Signature of
Role |
Plan administrator |
Date |
2015-01-19 |
Name of individual signing |
MEGAN KNEEBONE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-19 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK BROTHERS COMPANY SHOP EMPLOYEES PENSION PLAN
|
2012
|
360810680
|
2014-01-17
|
BLACK BROS. CO.
|
40
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1960-07-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410
|
Signature of
Role |
Plan administrator |
Date |
2014-01-17 |
Name of individual signing |
ROBERT STACHLEWITZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-01-17 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLACK BROTHERS COMPANY SHOP EMPLOYEES PENSION PLAN
|
2011
|
360810680
|
2013-01-18
|
BLACK BROS. CO.
|
42
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1960-07-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410
|
Plan administrator’s name and address
Administrator’s EIN |
360810680 |
Plan administrator’s name |
BLACK BROS. CO. |
Plan administrator’s
address |
501 NINTH AVENUE, P.O. BOX 410, MENDOTA, IL, 613420410 |
Administrator’s telephone number |
8155397451 |
Signature of
Role |
Plan administrator |
Date |
2013-01-18 |
Name of individual signing |
ROBERT STACHLEWITZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-01-18 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE BLACK BROS. CO. EMPLOYEE BENEFIT PLAN
|
2011
|
360810680
|
2012-07-26
|
THE BLACK BROS. CO.
|
24
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1998-01-01
|
Business code |
333900
|
Sponsor’s telephone number |
8155397451
|
Plan sponsor’s mailing address |
P.O. BOX 410, MENDOTA, IL, 61342
|
Plan sponsor’s
address |
501 9TH AVENUE, MENDOTA, IL, 61342
|
Plan administrator’s name and address
Administrator’s EIN |
360810680 |
Plan administrator’s name |
THE BLACK BROS. CO. |
Plan administrator’s
address |
P.O. BOX 410, MENDOTA, IL, 61342 |
Administrator’s telephone number |
8155397451 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-26 |
Name of individual signing |
ROBERT STACHLEWITZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-26 |
Name of individual signing |
JEFFREY SIMONTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|