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  5. K. C. ERICKSON DENTAL LABORATORIES, INC.

K. C. ERICKSON DENTAL LABORATORIES, INC.

Company Details

Entity Name: K. C. ERICKSON DENTAL LABORATORIES, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Foreign BCA
Status: Revoked
Date Formed: 03 Jan 1963
Company Number: CORP_16223093
File Number: 16223093
Date Status Change: 11 Jun 2021
Place of Formation: DELAWARE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
K. C. ERICKSON DENTAL LABORATORIES, INC. PROFIT SHARING PLAN 2016 362495536 2018-04-23 K. C. ERICKSON DENTAL LABORATORIES, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-07-01
Business code 621399
Sponsor’s telephone number 8152323181
Plan sponsor’s address 260 WEST SOUTH STREET, FREEPORT, IL, 610326830

Signature of
Role Plan administrator
Date 2018-04-23
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-23
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
K. C. ERICKSON DENTAL LABORATORIES, INC. PROFIT SHARING PLAN 2015 362495536 2017-02-15 K. C. ERICKSON DENTAL LABORATORIES, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-07-01
Business code 621399
Sponsor’s telephone number 8152323181
Plan sponsor’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830

Signature of
Role Plan administrator
Date 2017-02-15
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-02-15
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
K. C. ERICKSON DENTAL LABORATORIES, INC. PROFIT SHARING PLAN 2014 362495536 2016-03-03 K. C. ERICKSON DENTAL LABORATORIES, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-07-01
Business code 621399
Sponsor’s telephone number 8152323181
Plan sponsor’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830

Signature of
Role Plan administrator
Date 2016-03-03
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-03-03
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
K. C. ERICKSON DENTAL LABORATORIES, INC. PROFIT SHARING PLAN 2013 362495536 2015-02-26 K. C. ERICKSON DENTAL LABORATORIES, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-07-01
Business code 621399
Sponsor’s telephone number 8152323181
Plan sponsor’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830

Signature of
Role Plan administrator
Date 2015-02-26
Name of individual signing KIM HEMESATH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-02-26
Name of individual signing KIM HEMESATH
Valid signature Filed with authorized/valid electronic signature
K. C. ERICKSON DENTAL LABORATORIES, INC. PROFIT SHARING PLAN 2012 362495536 2014-02-14 K. C. ERICKSON DENTAL LABORATORIES, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-07-01
Business code 621399
Sponsor’s telephone number 8152323181
Plan sponsor’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830

Signature of
Role Plan administrator
Date 2014-02-14
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-02-14
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
K. C. ERICKSON DENTAL LABORATORIES, INC. PROFIT SHARING PLAN 2011 362495536 2013-04-22 K. C. ERICKSON DENTAL LABORATORIES, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-07-01
Business code 621399
Sponsor’s telephone number 8152323181
Plan sponsor’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830

Plan administrator’s name and address
Administrator’s EIN 362495536
Plan administrator’s name K. C. ERICKSON DENTAL LABORATORIES, INC.
Plan administrator’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830
Administrator’s telephone number 8152323181

Signature of
Role Plan administrator
Date 2013-04-22
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-22
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
K. C. ERICKSON DENTAL LABORATORIES, INC. PROFIT SHARING PLAN 2010 362495536 2012-01-06 K. C. ERICKSON DENTAL LABORATORIES, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-07-01
Business code 621399
Sponsor’s telephone number 8152323181
Plan sponsor’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830

Plan administrator’s name and address
Administrator’s EIN 362495536
Plan administrator’s name K. C. ERICKSON DENTAL LABORATORIES, INC.
Plan administrator’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830
Administrator’s telephone number 8152323181

Signature of
Role Plan administrator
Date 2012-01-06
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-01-06
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
K. C. ERICKSON DENTAL LABORATORIES, INC. PROFIT SHARING PLAN 2009 362495536 2010-12-28 K. C. ERICKSON DENTAL LABORATORIES, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-07-01
Business code 621399
Sponsor’s telephone number 8152323181
Plan sponsor’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830

Plan administrator’s name and address
Administrator’s EIN 362495536
Plan administrator’s name K. C. ERICKSON DENTAL LABORATORIES, INC.
Plan administrator’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830
Administrator’s telephone number 8152323181

Signature of
Role Plan administrator
Date 2010-12-28
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-12-28
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
K. C. ERICKSON DENTAL LABORATORIES, INC. PROFIT SHARING PLAN 2009 362495536 2010-12-28 K. C. ERICKSON DENTAL LABORATORIES, INC. 16
Three-digit plan number (PN) 001
Effective date of plan 1967-07-01
Business code 621399
Sponsor’s telephone number 8152323181
Plan sponsor’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830

Plan administrator’s name and address
Administrator’s EIN 362495536
Plan administrator’s name K. C. ERICKSON DENTAL LABORATORIES, INC.
Plan administrator’s address 260 WEST SOUTH STREET, P.O. BOX 508, FREEPORT, IL, 610326830
Administrator’s telephone number 8152323181

Signature of
Role Plan administrator
Date 2010-12-28
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-12-28
Name of individual signing KIM P. HEMESATH
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MR K P HEMESATH, 260 W SOUTH ST, FREEPORT, 61032, STEPHENSON Agent 2003-01-09

President

Name and Address Role
KIM P HEMESATH 260 W SOUTH STFREEPORT IL, 61032 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 3000 1500000 10

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State

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