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  5. HARDIN COUNTY GENERAL HOSPITAL

HARDIN COUNTY GENERAL HOSPITAL

Company Details

Entity Name: HARDIN COUNTY GENERAL HOSPITAL
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 11 Feb 1953
Company Number: CORP_33581921
File Number: 33581921
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
SEFLHLR8RZS5 2024-12-07 6 FERRELL RD, ROSICLARE, IL, 62982, 1052, USA 6 FERRELL RD, ROSICLARE, IL, 62982, 1052, USA

Business Information
Congressional District 12
State/Country of Incorporation IL, USA
Activation Date 2023-12-12
Initial Registration Date 2004-02-02
Entity Start Date 1953-02-11
Fiscal Year End Close Date Mar 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name SUSIE DEGRAVE
Role HUMAN RESOURCES
Address 6 FERRELL RD, ROSICLARE, IL, 62982, 1052, USA
Government Business
Title PRIMARY POC
Name ROBY WILLIAMS
Role CEO
Address 6 FERRELL ROAD, ROSICLARE, IL, 62982, 1052, USA
Title ALTERNATE POC
Name ROBY WILLIAMS
Address 6 FERRELL RD, ROSICLARE, IL, 62982, 2467, USA
Past Performance
Title PRIMARY POC
Name HALEY DUKE
Role CLINIC DIRECTOR
Address 6 FERRELL RD, ROSICLARE, IL, 62982, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2023 370702309 2024-10-11 HARDIN COUNTY GENERAL HOSPITAL 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address 6 FERRELL ROAD, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2024-10-11
Name of individual signing SUSIE DEGRAVE
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2022 370702309 2023-10-16 HARDIN COUNTY GENERAL HOSPITAL 21
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address P.O. BOX 2467, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing ROBY WILLIAMS
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2021 370702309 2022-10-17 HARDIN COUNTY GENERAL HOSPITAL 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address P.O. BOX 2467, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing ROBY WILLIAMS
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2020 370702309 2021-10-15 HARDIN COUNTY GENERAL HOSPITAL 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address P.O. BOX 2467, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing ROBY WILLIAMS
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2020 370702309 2021-10-13 HARDIN COUNTY GENERAL HOSPITAL 19
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address P.O. BOX 2467, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing ROBY WILLIAMS
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2020 370702309 2021-10-12 HARDIN COUNTY GENERAL HOSPITAL 19
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address P.O. BOX 2467, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2021-10-12
Name of individual signing ROBY WILLIAMS
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2019 370702309 2020-10-13 HARDIN COUNTY GENERAL HOSPITAL 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address P.O. BOX 2467, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2020-10-13
Name of individual signing ROBY WILLIAMS
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2018 370702309 2019-10-11 HARDIN COUNTY GENERAL HOSPITAL 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address P.O. BOX 2467, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2019-10-11
Name of individual signing ROBY WILLIAMS
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 370702309 2018-10-05 HARDIN COUNTY GENERAL HOSPITAL 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address P.O. BOX 2467, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2018-10-05
Name of individual signing ROBY WILLIAMS
Valid signature Filed with authorized/valid electronic signature
HARDIN COUNTY GENERAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 370702309 2017-10-12 HARDIN COUNTY GENERAL HOSPITAL 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1967-04-01
Business code 622000
Sponsor’s telephone number 6182856634
Plan sponsor’s address P.O. BOX 2467, ROSICLARE, IL, 62982

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing ROBY WILLIAMS
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ROBY D WILLIAMS, FERRELL RD, ROSICLARE, 62982, HARDIN Agent 1982-02-02

Related by officers

No related officers

Related by address

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Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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