RANDALL OLIVA, D.D.S., P.C. 401(K) P/S PLAN
|
2011
|
260004082
|
2012-09-21
|
RANDALL OLIVA, D.D.S., P.C.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8472922700
|
Plan sponsor’s
address |
650 N. NORTHWEST HIGHWAY, PARK RIDGE, IL, 600682554
|
Plan administrator’s name and address
Administrator’s EIN |
260004082 |
Plan administrator’s name |
RANDALL OLIVA, D.D.S., P.C. |
Plan administrator’s
address |
650 N. NORTHWEST HIGHWAY, PARK RIDGE, IL, 600682554 |
Administrator’s telephone number |
8472922700 |
Signature of
Role |
Plan administrator |
Date |
2012-09-21 |
Name of individual signing |
RANDALL OLIVA, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-09-21 |
Name of individual signing |
RANDALL OLIVA, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RANDALL OLIVA, D.D.S., P.C. 401(K) P/S PLAN
|
2010
|
260004082
|
2012-09-21
|
RANDALL OLIVA, D.D.S., P.C.
|
10
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8472922700
|
Plan sponsor’s
address |
650 N. NORTHWEST HIGHWAY, PARK RIDGE, IL, 600682554
|
Plan administrator’s name and address
Administrator’s EIN |
260004082 |
Plan administrator’s name |
RANDALL OLIVA, D.D.S., P.C. |
Plan administrator’s
address |
650 N. NORTHWEST HIGHWAY, PARK RIDGE, IL, 600682554 |
Administrator’s telephone number |
8472922700 |
Signature of
Role |
Plan administrator |
Date |
2012-09-20 |
Name of individual signing |
RANDALL OLIVA, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-09-20 |
Name of individual signing |
RANDALL OLIVA, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RANDALL OLIVA, D.D.S., P.C. 401(K) P/S PLAN
|
2010
|
260004082
|
2011-10-14
|
RANDALL OLIVA, D.D.S., P.C.
|
8
|
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8472922700
|
Plan sponsor’s
address |
1338 S. CHESTER AVENUE, PARK RIDGE, IL, 600685106
|
Plan administrator’s name and address
Administrator’s EIN |
260004082 |
Plan administrator’s name |
RANDALL OLIVA, D.D.S., P.C. |
Plan administrator’s
address |
1338 S. CHESTER AVENUE, PARK RIDGE, IL, 600685106 |
Administrator’s telephone number |
8472922700 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
RANDALL OLIVA, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-10-14 |
Name of individual signing |
RANDALL OLIVA, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
RANDALL OLIVA, D.D.S., P.C. 401(K) P/S PLAN
|
2009
|
260004082
|
2010-10-08
|
RANDALL OLIVA, D.D.S., P.C.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2004-01-01
|
Business code |
621210
|
Sponsor’s telephone number |
8472922700
|
Plan sponsor’s
address |
1338 S. CHESTER AVENUE, PARK RIDGE, IL, 600685106
|
Plan administrator’s name and address
Administrator’s EIN |
260004082 |
Plan administrator’s name |
RANDALL OLIVA, D.D.S., P.C. |
Plan administrator’s
address |
1338 S. CHESTER AVENUE, PARK RIDGE, IL, 600685106 |
Administrator’s telephone number |
8472922700 |
Signature of
Role |
Plan administrator |
Date |
2010-10-08 |
Name of individual signing |
RANDALL OLIVA, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-08 |
Name of individual signing |
RANDALL OLIVA, D.D.S. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|