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  5. THE ACADEMY OF GENERAL DENTISTRY

THE ACADEMY OF GENERAL DENTISTRY

Company Details

Entity Name: THE ACADEMY OF GENERAL DENTISTRY
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 02 Aug 1952
Company Number: CORP_33269757
File Number: 33269757
Address 211 E CHICAGO AVE, CHICAGO, IL, 60611
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ACADEMY OF GENERAL DENTISTRY RETIREMENT SAVINGS 2023 366107533 2024-04-22 ACADEMY OF GENERAL DENTISTRY 91
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-08-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2024-04-22
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-04-22
Name of individual signing KATINA LOFTON
Valid signature Filed with incorrect/unrecognized electronic signature
ACADEMY OF GENERAL DENTISTRY RETIREMENT SAVINGS 2022 366107533 2023-07-06 ACADEMY OF GENERAL DENTISTRY 86
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-08-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2023-07-06
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-06
Name of individual signing KATINA LOFTON
Valid signature Filed with incorrect/unrecognized electronic signature
ACADEMY OF GENERAL DENTISTRY RETIREMENT SAVINGS 2021 366107533 2022-07-19 ACADEMY OF GENERAL DENTISTRY 94
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-08-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2022-07-19
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
ACADEMY OF GENERAL DENTISTRY 457(B) PLAN 2020 366107533 2021-10-11 ACADEMY OF GENERAL DENTISTRY 1
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2013-12-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-11
Name of individual signing KATINA LOFTON
Valid signature Filed with incorrect/unrecognized electronic signature
ACADEMY OF GENERAL DENTISTRY RETIREMENT SAVINGS 2020 366107533 2021-06-11 ACADEMY OF GENERAL DENTISTRY 97
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-08-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2021-06-11
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
ACADEMY OF GENERAL DENTISTRY RETIREMENT SAVINGS 2019 366107533 2020-07-01 ACADEMY OF GENERAL DENTISTRY 94
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-08-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2020-07-01
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-01
Name of individual signing KATINA LOFTON
Valid signature Filed with incorrect/unrecognized electronic signature
ACADEMY OF GENERAL DENTISTRY 457(B) PLAN 2019 366107533 2020-09-25 ACADEMY OF GENERAL DENTISTRY 1
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2013-12-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2020-09-25
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-25
Name of individual signing KATINA LOFTON
Valid signature Filed with incorrect/unrecognized electronic signature
ACADEMY OF GENERAL DENTISTRY RETIREMENT SAVINGS 2018 366107533 2019-10-09 ACADEMY OF GENERAL DENTISTRY 92
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-08-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-09
Name of individual signing KATINA LOFTON
Valid signature Filed with incorrect/unrecognized electronic signature
ACADEMY OF GENERAL DENTISTRY 457(B) PLAN 2018 366107533 2019-08-06 ACADEMY OF GENERAL DENTISTRY 1
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2013-12-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2019-08-06
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-06
Name of individual signing KATINA LOFTON
Valid signature Filed with authorized/valid electronic signature
ACADEMY OF GENERAL DENTISTRY RETIREMENT SAVINGS 2017 366107533 2018-07-30 ACADEMY OF GENERAL DENTISTRY 94
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-08-01
Business code 813000
Sponsor’s telephone number 3124404300
Plan sponsor’s address 560 W. LAKE STREET SIXTH FLOOR, CHICAGO, IL, 606616600

Signature of
Role Plan administrator
Date 2018-07-30
Name of individual signing DANIEL BUKSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-30
Name of individual signing KATINA LOFTON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
COLLEEN LAWLER, 560 W LAKE ST FLOOR 6, CHICAGO, 60661, COOK-NOT IN CITY OF CHICAGO Agent 2024-08-07

Related by officers

No related officers

Related by address

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Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State

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