BURBANK VISION, INC. PENSION PLAN AND TRUST
|
2012
|
363784727
|
2013-10-10
|
BURBANK VISION, INC.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
7084253540
|
Plan sponsor’s
address |
2841 S. HOME AVENUE, BERWYN, IL, 60402
|
Plan administrator’s name and address
Administrator’s EIN |
363784727 |
Plan administrator’s name |
BURBANK VISION, INC. |
Plan administrator’s
address |
2841 S. HOME AVENUE, BERWYN, IL, 60402 |
Administrator’s telephone number |
7084253540 |
Signature of
Role |
Plan administrator |
Date |
2013-10-10 |
Name of individual signing |
CHARLES B. GOODMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BURBANK VISION, INC. PENSION PLAN AND TRUST
|
2011
|
363784727
|
2012-10-14
|
BURBANK VISION, INC.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
7084253540
|
Plan sponsor’s
address |
2841 S. HOME AVENUE, BERWYN, IL, 60402
|
Plan administrator’s name and address
Administrator’s EIN |
363784727 |
Plan administrator’s name |
BURBANK VISION, INC. |
Plan administrator’s
address |
2841 S. HOME AVENUE, BERWYN, IL, 60402 |
Administrator’s telephone number |
7084253540 |
Signature of
Role |
Plan administrator |
Date |
2012-10-14 |
Name of individual signing |
CHARLES B. GOODMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BURBANK VISION, INC. PENSION PLAN AND TRUST
|
2010
|
363784727
|
2011-10-26
|
BURBANK VISION, INC.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
7084253540
|
Plan sponsor’s
address |
2841 S. HOME AVENUE, BERWYN, IL, 60402
|
Plan administrator’s name and address
Administrator’s EIN |
363784727 |
Plan administrator’s name |
BURBANK VISION, INC. |
Plan administrator’s
address |
2841 S. HOME AVENUE, BERWYN, IL, 60402 |
Administrator’s telephone number |
7084253540 |
Signature of
Role |
Plan administrator |
Date |
2011-10-26 |
Name of individual signing |
CHARLES B. GOODMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BURBANK VISION, INC. PENSION PLAN AND TRUST
|
2009
|
363784727
|
2012-10-14
|
BURBANK VISION, INC.
|
15
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2000-01-01
|
Business code |
621320
|
Sponsor’s telephone number |
7084253540
|
Plan sponsor’s
address |
2841 S. HOME AVENUE, BERWYN, IL, 60402
|
Plan administrator’s name and address
Administrator’s EIN |
363784727 |
Plan administrator’s name |
BURBANK VISION, INC. |
Plan administrator’s
address |
2841 S. HOME AVENUE, BERWYN, IL, 60402 |
Administrator’s telephone number |
7084253540 |
Signature of
Role |
Plan administrator |
Date |
2012-10-14 |
Name of individual signing |
CHARLES B. GOODMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|