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  5. FAMILY SERVICE AGENCY OF DEKALB COUNTY, ILLINOIS, INC.

FAMILY SERVICE AGENCY OF DEKALB COUNTY, ILLINOIS, INC.

Company Details

Entity Name: FAMILY SERVICE AGENCY OF DEKALB COUNTY, ILLINOIS, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 18 Jul 1956
Company Number: CORP_36269545
File Number: 36269545
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
TLQ3P9L7YB39 2025-03-25 1325 SYCAMORE RD, DEKALB, IL, 60115, 2483, USA 1325 SYCAMORE ROAD, DEKALB, IL, 60115, 9637, USA

Business Information
Doing Business As CHILDRENS ADVOCACY CENTER OF DEKALB COUNTY
URL fsadekalbcounty.org
Division Name FAMILY SERVICE AGENCY OF DEKALB COUNTY, ILLINOIS, INC.
Division Number FAMILY SER
Congressional District 14
State/Country of Incorporation IL, USA
Activation Date 2024-03-27
Initial Registration Date 2009-04-14
Entity Start Date 1956-07-18
Fiscal Year End Close Date Jun 30

Points of Contacts
Electronic Business
Title PRIMARY POC
Name HOLLY PEIFER
Role CAC DIRECTOR
Address 1325 SYCAMORE ROAD, DEKALB, IL, 60115, USA
Title ALTERNATE POC
Name TYNISHA CLEGG
Role EXECUTIVE DIRECTOR
Address 14 HEALTH SERVICES DRIVE, DEKALB, IL, 60115, USA
Government Business
Title PRIMARY POC
Name TYNISHA CLEGG
Role EXECUTIVE DIRECTOR
Address 1325 SYCAMORE ROAD, DEKALB, IL, 60115, USA
Title ALTERNATE POC
Name TYNISHA CLEGG
Role EXECUTIVE DIRECTOR
Address 14 HEALTH SERVICES DRIVE, DEKALB, IL, 60115, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY SERVICE AGENCY OF DEKALB COUNTY EMPLOYEES' RETIREMENT PLAN 2015 362360012 2016-07-07 FAMILY SERVICE AGENCY OF DEKALB COUNTY INC. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621410
Sponsor’s telephone number 8157588616
Plan sponsor’s address 14 HEALTH SERVICES DRIVE, DEKALB, IL, 601159637

Signature of
Role Plan administrator
Date 2016-07-07
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-07
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
FAMILY SERVICE AGENCY CODE 403(B) PLAN 2015 362360012 2016-07-07 FAMILY SERVICE AGENCY OF DEKALB COUNTY, INC. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621410
Sponsor’s telephone number 8157588616
Plan sponsor’s address 14 HEALTH SERVICES DRIVE, DEKALB, IL, 601159637

Signature of
Role Plan administrator
Date 2016-07-07
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-07
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
FAMILY SERVICE AGENCY CODE 403(B) PLAN 2014 362360012 2015-07-27 FAMILY SERVICE AGENCY OF DEKALB COUNTY, INC. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621410
Sponsor’s telephone number 8157588616
Plan sponsor’s address 14 HEALTH SERVICES DRIVE, DEKALB, IL, 601159637

Signature of
Role Plan administrator
Date 2015-07-27
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-27
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
FAMILY SERVICE AGENCY OF DEKALB COUNTY EMPLOYEES' RETIREMENT PLAN 2014 362360012 2015-07-27 FAMILY SERVICE AGENCY OF DEKALB COUNTY INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621410
Sponsor’s telephone number 8157588616
Plan sponsor’s address 14 HEALTH SERVICES DRIVE, DEKALB, IL, 601159637

Signature of
Role Plan administrator
Date 2015-07-27
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-27
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
FAMILY SERVICE AGENCY CODE 403(B) PLAN 2013 362360012 2014-07-28 FAMILY SERVICE AGENCY OF DEKALB COUNTY, INC. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 621410
Sponsor’s telephone number 8157588616
Plan sponsor’s address 14 HEALTH SERVICES DRIVE, DEKALB, IL, 601159637

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-28
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
FAMILY SERVICE AGENCY OF DEKALB COUNTY EMPLOYEES' RETIREMENT PLAN 2013 362360012 2014-07-28 FAMILY SERVICE AGENCY OF DEKALB COUNTY INC. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621410
Sponsor’s telephone number 8157588616
Plan sponsor’s address 14 HEALTH SERVICES DRIVE, DEKALB, IL, 601159637

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-28
Name of individual signing DAVID C. MILLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
TYNISHA L CLEGG, 1325 SYCAMORE RD, DEKALB, 60115, DE KALB Agent 2019-12-17

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
DEKALB COUNTY YOUTH SERVICES BUREAU, INC. NFP Assume Name 2023-02-07 No data No data No data
FAMILY SERVICE AGENCY OF DEKALB COUNTY, INC. NFP Assume Name 2020-04-28 No data No data No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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