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  5. FORSYTH INSURANCE GROUP, INC.

FORSYTH INSURANCE GROUP, INC.

Company Details

Entity Name: FORSYTH INSURANCE GROUP, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 13 Feb 1963
Company Number: CORP_42804029
File Number: 42804029
Type of Business: Business Corporations
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2022 370818892 2023-09-06 FORSYTH INSURANCE GROUP, INC. 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 62703

Signature of
Role Plan administrator
Date 2023-09-06
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2022 370818892 2023-09-06 FORSYTH INSURANCE GROUP, INC. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 62703

Signature of
Role Plan administrator
Date 2023-09-06
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2021 370818892 2022-09-27 FORSYTH INSURANCE GROUP, INC. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 62703

Signature of
Role Plan administrator
Date 2022-09-27
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2020 370818892 2021-07-20 FORSYTH INSURANCE GROUP, INC. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 62703

Signature of
Role Plan administrator
Date 2021-07-20
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2019 370818892 2020-07-28 FORSYTH INSURANCE GROUP, INC. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 62703

Signature of
Role Plan administrator
Date 2020-07-28
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2018 370818892 2019-07-19 FORSYTH INSURANCE GROUP, INC. 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 62703

Signature of
Role Plan administrator
Date 2019-07-19
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2017 370818892 2018-07-05 FORSYTH INSURANCE GROUP, INC. 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 62703

Signature of
Role Plan administrator
Date 2018-07-05
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2016 370818892 2017-07-10 FORSYTH INSURANCE GROUP 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 627032229

Signature of
Role Plan administrator
Date 2017-07-10
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2015 370818892 2016-07-07 FORSYTH INSURANCE GROUP 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 627032229

Signature of
Role Plan administrator
Date 2016-07-07
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature
FORSYTH INSURANCE GROUP, INC. 401(K) PLAN 2014 370818892 2015-10-14 FORSYTH INSURANCE GROUP, INC. 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 524210
Sponsor’s telephone number 2175259500
Plan sponsor’s address PO BOX 2229, SPRINGFIELD, IL, 627032229

Signature of
Role Plan administrator
Date 2015-10-14
Name of individual signing DALE BLANKENSHIP
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
GREGORY A CANNEDY, 430 E VINE ST, SPRINGFIELD, 62703, SANGAMON Agent 2023-07-28

President

Name and Address Role
GREGORY A CANNEDY 11268 HOBBS RD ROCHESTER 62563 President

Secretary

Name and Address Role
GREGORY A CANNEDY 11268 HOBBS RD ROCHESTER 62563 Secretary

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
MONEY SERVICE COMPANY No data 1990-07-26 2015-04-01 Voluntary Cancellation No data

Historical Names

Name Change Date
FORSYTH INSURANCE AGENCY, INC. 1991-12-26

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100000 2000000 1

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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