ROBERT A. LARSON,O.D., P.C. PROFIT SHARING PLAN
|
2012
|
363882270
|
2013-07-22
|
ROBERT A. LARSON,O.D., P.C.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-05-01
|
Business code |
621320
|
Sponsor’s telephone number |
8154368955
|
Plan sponsor’s
address |
15420 S. ROUTE 59, PLAINFIELD, IL, 60544
|
Signature of
Role |
Plan administrator |
Date |
2013-07-22 |
Name of individual signing |
MARY LOU LARSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-22 |
Name of individual signing |
MARY LOU LARSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT A. LARSON,O.D., P.C. PROFIT SHARING PLAN
|
2011
|
363882270
|
2012-07-27
|
ROBERT A. LARSON, O.D., P.C.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-05-01
|
Business code |
621320
|
Sponsor’s telephone number |
8154368955
|
Plan sponsor’s
address |
15420 S. ROUTE 59, PLAINFIELD, IL, 60544
|
Plan administrator’s name and address
Administrator’s EIN |
363882270 |
Plan administrator’s name |
ROBERT A. LARSON, O.D., P.C. |
Plan administrator’s
address |
15420 S. ROUTE 59, PLAINFIELD, IL, 60544 |
Administrator’s telephone number |
8154368955 |
Signature of
Role |
Plan administrator |
Date |
2012-07-27 |
Name of individual signing |
MARY LOU LARSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT A. LARSON, O.D., P.C. PROFIT SHARING PLAN
|
2010
|
363882270
|
2011-07-29
|
ROBERT A. LARSON, O.D., P.C.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-05-01
|
Business code |
621320
|
Sponsor’s telephone number |
8154368955
|
Plan sponsor’s
address |
15420 S. ROUTE 59, PLAINFIELD, IL, 60544
|
Plan administrator’s name and address
Administrator’s EIN |
363882270 |
Plan administrator’s name |
ROBERT A. LARSON, O.D., P.C. |
Plan administrator’s
address |
15420 S. ROUTE 59, PLAINFIELD, IL, 60544 |
Administrator’s telephone number |
8154368955 |
Signature of
Role |
Plan administrator |
Date |
2011-07-29 |
Name of individual signing |
MARY LOU LARSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ROBERT A. LARSON, O.D., P.C. PROFIT SHARING PLAN
|
2009
|
363882270
|
2010-10-12
|
ROBERT A. LARSON, O.D., P.C.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1993-05-01
|
Business code |
621320
|
Sponsor’s telephone number |
8154368955
|
Plan sponsor’s
address |
15420 S. ROUTE 59, PLAINFIELD, IL, 60544
|
Plan administrator’s name and address
Administrator’s EIN |
363882270 |
Plan administrator’s name |
ROBERT A. LARSON, O.D., P.C. |
Plan administrator’s
address |
15420 S. ROUTE 59, PLAINFIELD, IL, 60544 |
Administrator’s telephone number |
8154368955 |
Signature of
Role |
Plan administrator |
Date |
2010-10-12 |
Name of individual signing |
MARY LOU LARSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|