|
FIXED TAX DEFFERED ANNUITY PLAN VOLUNTARY
|
2009
|
410706115
|
2010-07-28
|
MADISON LUTHERAN HOME
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
004
|
| Effective date of plan |
1991-09-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
3205987536
|
| Plan sponsor’s
address |
900 2ND AVE, MADISON, MN, 56256
|
Plan administrator’s name and address
| Administrator’s EIN |
410706115 |
| Plan administrator’s name |
MADISON LUTHERAN HOME |
| Plan administrator’s
address |
900 2ND AVE, MADISON, MN, 56256 |
| Administrator’s telephone number |
3205987536 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-27 |
| Name of individual signing |
SCOTT LARSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FIXED TAX DEFFERED ANNUITY PLAN-VOLUNTARY
|
2009
|
410706115
|
2010-07-28
|
MADISON LUTHERAN HOME
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1976-05-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
3205987536
|
| Plan sponsor’s
address |
900 2ND AVE, MADISON, MN, 56256
|
Plan administrator’s name and address
| Administrator’s EIN |
410706115 |
| Plan administrator’s name |
MADISON LUTHERAN HOME |
| Plan administrator’s
address |
900 2ND AVE, MADISON, MN, 56256 |
| Administrator’s telephone number |
3205987536 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-27 |
| Name of individual signing |
SCOTT LARSON |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
