|
INDEPENDENT LIVING SERVICES, INC. RETIREMENT PLAN AND TRUST
|
2021
|
820474101
|
2023-04-05
|
INDEPENDENT LIVING SERVICES, INC.
|
21
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-10-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
2083755155
|
| Plan sponsor’s mailing address |
PO BOX 6395, BOISE, ID, 837076395
|
| Plan sponsor’s
address |
PO BOX 6395, BOISE, ID, 837076395
|
Number of participants as of the end of the plan year
| Active participants |
13 |
| Other
retired or separated participants entitled to future benefits |
8 |
| Number of
participants
with
account balances as of the end of the plan year |
21 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
4 |
Signature of
| Role |
Plan administrator |
| Date |
2023-04-05 |
| Name of individual signing |
TAMARA MALONE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
INDEPENDENT LIVING SERVICES, INC. RETIREMENT PLAN AND TRUST
|
2020
|
820474101
|
2022-05-12
|
INDEPENDENT LIVING SERVICES, INC.
|
24
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-10-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
2083755155
|
| Plan sponsor’s mailing address |
PO BOX 6395, BOISE, ID, 837076395
|
| Plan sponsor’s
address |
PO BOX 6395, BOISE, ID, 837076395
|
Number of participants as of the end of the plan year
| Active participants |
21 |
| Number of
participants
with
account balances as of the end of the plan year |
21 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
3 |
Signature of
| Role |
Plan administrator |
| Date |
2022-05-12 |
| Name of individual signing |
TAMARA MALONE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
INDEPENDENT LIVING SERVICES INC RETIREMENT PLAN AND TRUST
|
2010
|
820474101
|
2011-12-20
|
INDEPENDENT LIVING SERVICES, INC
|
43
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-10-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
2083755155
|
| Plan sponsor’s mailing address |
PO BOX 6395, BOISE, ID, 83707
|
| Plan sponsor’s
address |
10332 FAIRVIEW AVENUE, BOISE, ID, 83707
|
Plan administrator’s name and address
| Administrator’s EIN |
820474101 |
| Plan administrator’s name |
INDEPENDENT LIVING SERVICES INC |
| Plan administrator’s
address |
PO BOX 6395, BOISE, ID, 83707 |
| Administrator’s telephone number |
2083755155 |
Number of participants as of the end of the plan year
| Active participants |
30 |
| Other
retired or separated participants entitled to future benefits |
2 |
| Number of
participants
with
account balances as of the end of the plan year |
27 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
18 |
Signature of
| Role |
Plan administrator |
| Date |
2011-12-19 |
| Name of individual signing |
MICHAEL DAY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
INDEPENDENT LIVING SERVICES INC RETIREMENT PLAN AND TRUST
|
2009
|
820474101
|
2010-11-19
|
INDEPENDENT LIVING SERVICES, INC
|
42
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1994-10-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
2083755155
|
| Plan sponsor’s mailing address |
PO BOX 6395, BOISE, ID, 83707
|
| Plan sponsor’s
address |
10332 FAIRVIEW AVENUE, BOISE, ID, 83707
|
Plan administrator’s name and address
| Administrator’s EIN |
820474101 |
| Plan administrator’s name |
INDEPENDENT LIVING SERVICES INC |
| Plan administrator’s
address |
PO BOX 6395, BOISE, ID, 83707 |
| Administrator’s telephone number |
2083755155 |
Number of participants as of the end of the plan year
| Active participants |
38 |
| Other
retired or separated participants entitled to future benefits |
5 |
| Number of
participants
with
account balances as of the end of the plan year |
43 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
7 |
Signature of
| Role |
Plan administrator |
| Date |
2010-11-19 |
| Name of individual signing |
MICHAEL DAY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
