UROLOGICAL SURGEONS OF ILLINOIS, LTD. PROFIT SHARING PLAN AND TRUST
|
2011
|
363123406
|
2012-10-10
|
UROLOGICAL SURGEONS OF ILLINOIS, LTD.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1981-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159374006
|
Plan sponsor’s
address |
375 NORTH WALL STREET - SUITE P530, KANKAKEE, IL, 609013486
|
Plan administrator’s name and address
Administrator’s EIN |
363341096 |
Plan administrator’s name |
JOEL N. SLUTSKY, M.D. |
Plan administrator’s
address |
375 NORTH WALL STREET -SUITE P530, KANKAKEE, IL, 609013486 |
Administrator’s telephone number |
8159374006 |
Signature of
Role |
Plan administrator |
Date |
2012-10-10 |
Name of individual signing |
JOEL N. SLUTSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UROLOGICAL SURGEONS OF ILLINOIS, LTD. PROFIT SHARING PLAN AND TRUST
|
2010
|
363123406
|
2011-09-29
|
UROLOGICAL SURGEONS OF ILLINOIS, LTD.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1981-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159374006
|
Plan sponsor’s
address |
375 NORTH WALL STREET - SUITE P530, KANKAKEE, IL, 609013486
|
Plan administrator’s name and address
Administrator’s EIN |
363341096 |
Plan administrator’s name |
JOEL N. SLUTSKY, M.D. |
Plan administrator’s
address |
375 NORTH WALL STREET -SUITE P530, KANKAKEE, IL, 609013486 |
Administrator’s telephone number |
8159374006 |
Signature of
Role |
Plan administrator |
Date |
2011-09-29 |
Name of individual signing |
JOEL N. SLUTSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-09-29 |
Name of individual signing |
JOEL N. SLUTSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UROLOGICAL SURGEONS OF ILLINOIS, LTD. PROFIT SHARING PLAN AND TRUST
|
2009
|
363123406
|
2010-09-30
|
UROLOGICAL SURGEONS OF ILLINOIS, LTD.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1981-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
8159374006
|
Plan sponsor’s
address |
375 NORTH WALL STREET - SUITE P530, KANKAKEE, IL, 609013486
|
Plan administrator’s name and address
Administrator’s EIN |
363341096 |
Plan administrator’s name |
JOEL N. SLUTSKY, M.D. |
Plan administrator’s
address |
375 NORTH WALL STREET -SUITE P530, KANKAKEE, IL, 609013486 |
Administrator’s telephone number |
8159374006 |
Signature of
Role |
Plan administrator |
Date |
2010-09-29 |
Name of individual signing |
JOEL N. SLUTSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-09-29 |
Name of individual signing |
JOEL N. SLUTSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|