JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC DEFINED BENEFIT PLAN & TRUST
|
2012
|
364374765
|
2013-10-03
|
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
8157441089
|
Plan sponsor’s
address |
1715 GLENWOOD AVE., JOLIET, IL, 604355835
|
Signature of
Role |
Plan administrator |
Date |
2013-10-03 |
Name of individual signing |
BHAVANI SIVARAJAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-03 |
Name of individual signing |
BHAVANI SIVARAJAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC DEFINED BENEFIT PLAN & TRUST
|
2011
|
364374765
|
2012-10-09
|
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
8157441089
|
Plan sponsor’s
address |
1715 GLENWOOD AVE., JOLIET, IL, 604355835
|
Plan administrator’s name and address
Administrator’s EIN |
364374765 |
Plan administrator’s name |
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC. |
Plan administrator’s
address |
1715 GLENWOOD AVE., JOLIET, IL, 604355835 |
Administrator’s telephone number |
8157441089 |
Signature of
Role |
Plan administrator |
Date |
2012-10-09 |
Name of individual signing |
BHAVANI SIVARAJAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC. DEFINED BENEFIT PLAN & TRUST
|
2010
|
364374765
|
2011-09-28
|
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
8157441089
|
Plan sponsor’s
address |
1715 GLENWOOD AVE., JOLIET, IL, 604355835
|
Plan administrator’s name and address
Administrator’s EIN |
364374765 |
Plan administrator’s name |
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC. |
Plan administrator’s
address |
1715 GLENWOOD AVE., JOLIET, IL, 604355835 |
Administrator’s telephone number |
8157441089 |
Signature of
Role |
Plan administrator |
Date |
2011-09-28 |
Name of individual signing |
BHAVANI SIVARAJAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC. DEFINED BENEFIT PLAN & TRUST
|
2009
|
364374765
|
2010-09-22
|
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
621399
|
Sponsor’s telephone number |
8157441089
|
Plan sponsor’s
address |
1715 GLENWOOD AVE., JOLIET, IL, 604355835
|
Plan administrator’s name and address
Administrator’s EIN |
364374765 |
Plan administrator’s name |
JOLIET DIABETES & ENDOCRINOLOGY ASSOCIATES, INC. |
Plan administrator’s
address |
1715 GLENWOOD AVE., JOLIET, IL, 604355835 |
Administrator’s telephone number |
8157441089 |
Signature of
Role |
Plan administrator |
Date |
2010-09-22 |
Name of individual signing |
BHAVANI SIVARAJAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|