|
WILLOW BRANCH FARMS LLC MEDOVA LIFESTYLE HEALTH PLAN
|
2021
|
820652815
|
2023-06-30
|
WILLOW BRANCH FARMS LLC
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2020-12-01
|
| Business code |
111100
|
| Sponsor’s telephone number |
2175199519
|
| Plan sponsor’s
address |
375 SECRETARIAT PL, MOUNT ZION, IL, 625499710
|
Plan administrator’s name and address
| Administrator’s EIN |
200200514 |
| Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number |
6153700051 |
Signature of
| Role |
Plan administrator |
| Date |
2023-06-30 |
| Name of individual signing |
ROBERT MOORE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
WILLOW BRANCH FARMS LLC MEDOVA LIFESTYLE HEALTH PLAN
|
2020
|
820652815
|
2022-09-02
|
WILLOW BRANCH FARMS LLC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2020-12-01
|
| Business code |
111100
|
| Sponsor’s telephone number |
2175199519
|
| Plan sponsor’s
address |
375 SECRETARIAT PL, MOUNT ZION, IL, 625499710
|
Plan administrator’s name and address
| Administrator’s EIN |
200200514 |
| Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number |
6153700051 |
Signature of
| Role |
Plan administrator |
| Date |
2022-08-29 |
| Name of individual signing |
ROBERT MOORE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
