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  5. FAIRHAVEN CHRISTIAN RETIREMENT CENTER

FAIRHAVEN CHRISTIAN RETIREMENT CENTER

Company Details

Entity Name: FAIRHAVEN CHRISTIAN RETIREMENT CENTER
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 29 Dec 1965
Company Number: CORP_46089511
File Number: 46089511
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAIRHAVEN CHRISTIAN RETIREMENT CENTER 2023 362606227 2024-07-10 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 137
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address KEITH PENNINGTON, 3470 N ALPINE RD, ROCKFORD, IL, 611144802
Plan sponsor’s address KEITH PENNINGTON, 3470 N ALPINE RD, ROCKFORD, IL, 611144802

Number of participants as of the end of the plan year
Active participants 142
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2024-07-10
Name of individual signing KEITH PENNINGTON
Valid signature Filed with authorized/valid electronic signature
FAIRHAVEN CHRISTIAN RETIREMENT CENTER 2022 362606227 2023-11-29 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 135
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address KEITH PENNINGTON, 3470 N ALPINE RD, ROCKFORD, IL, 611144802
Plan sponsor’s address KEITH PENNINGTON, 3470 N ALPINE RD, ROCKFORD, IL, 611144802

Number of participants as of the end of the plan year
Active participants 137
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2023-11-29
Name of individual signing KEITH PENNINGTON
Valid signature Filed with authorized/valid electronic signature
FAIRHAVEN CHRISTIAN RETIREMENT CENTER 2022 362606227 2023-11-29 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 140
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address KEITH PENNINGTON, 3470 N ALPINE RD, ROCKFORD, IL, 611144802
Plan sponsor’s address KEITH PENNINGTON, 3470 N ALPINE RD, ROCKFORD, IL, 611144802

Number of participants as of the end of the plan year
Active participants 145
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2023-11-29
Name of individual signing KEITH PENNINGTON
Valid signature Filed with authorized/valid electronic signature
FAIRHAVEN CHRISTIAN RETIREMENT CENTER 2021 362606227 2023-11-29 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 130
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address KEITH PENNINGTON, 3470 N ALPINE RD, ROCKFORD, IL, 611144802
Plan sponsor’s address KEITH PENNINGTON, 3470 N ALPINE RD, ROCKFORD, IL, 611144802

Number of participants as of the end of the plan year
Active participants 134
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2023-11-29
Name of individual signing KEITH PENNINGTON
Valid signature Filed with authorized/valid electronic signature
FAIRHAVEN CHRISTIAN RETIREMENT CENTER 2020 362606227 2021-09-14 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 147
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address 3470 N ALPINE RD, ROCKFORD, IL, 611144802
Plan sponsor’s address 3470 N ALPINE RD, ROCKFORD, IL, 611144802

Plan administrator’s name and address
Administrator’s EIN 362606227
Plan administrator’s name FAIRHAVEN CHRISTIAN RETIREMENT CENTER
Plan administrator’s address 3470 N ALPINE RD, ROCKFORD, IL, 611144802
Administrator’s telephone number 8158771441

Number of participants as of the end of the plan year
Active participants 135

Signature of
Role Plan administrator
Date 2021-09-14
Name of individual signing KEITH PENNINGTON
Valid signature Filed with authorized/valid electronic signature
FAIRHAVEN CHRISTIAN RETIREMENT CENTER GROUP LIFE INSURANCE PLAN 2018 362606227 2019-07-30 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 143
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114
Plan sponsor’s address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114

Number of participants as of the end of the plan year
Active participants 144

Signature of
Role Plan administrator
Date 2019-07-30
Name of individual signing JEFF REIERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-30
Name of individual signing JEFF REIERSON
Valid signature Filed with authorized/valid electronic signature
FAIRHAVEN CHRISTIAN RETIREMENT CENTER GROUP LIFE INSURANCE PLAN 2017 362606227 2019-06-19 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 146
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114
Plan sponsor’s address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114

Number of participants as of the end of the plan year
Active participants 143

Signature of
Role Plan administrator
Date 2019-06-19
Name of individual signing JEFF REIERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-19
Name of individual signing JEFF REIERSON
Valid signature Filed with authorized/valid electronic signature
FAIRHAVEN CHRISTIAN RETIREMENT CENTER GROUP LIFE INSURANCE PLAN 2016 362606227 2018-06-28 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 146
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114
Plan sponsor’s address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114

Number of participants as of the end of the plan year
Active participants 146

Signature of
Role Plan administrator
Date 2018-06-28
Name of individual signing JEFF REIERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-28
Name of individual signing JEFF REIERSON
Valid signature Filed with authorized/valid electronic signature
FAIRHAVEN CHRISTIAN RETIREMENT CENTER GROUP DENTAL INSURANCE PLAN 2015 362606227 2017-08-02 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 103
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2010-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114
Plan sponsor’s address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114

Number of participants as of the end of the plan year
Active participants 96

Signature of
Role Plan administrator
Date 2017-08-02
Name of individual signing JEFF REIERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-02
Name of individual signing JEFF REIERSON
Valid signature Filed with authorized/valid electronic signature
FAIRHAVEN CHRISTIAN RETIREMENT CENTER GROUP LIFE INSURANCE PLAN 2015 362606227 2017-08-02 FAIRHAVEN CHRISTIAN RETIREMENT CENTER 150
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 8158771441
Plan sponsor’s mailing address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114
Plan sponsor’s address 3470 N. ALPINE ROAD, ROCKFORD, IL, 61114

Number of participants as of the end of the plan year
Active participants 146

Signature of
Role Plan administrator
Date 2017-08-02
Name of individual signing JEFF REIERSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JEFFREY ROBERT REIERSON, 3470 N ALPINE RD, ROCKFORD, 61114, WINNEBAGO Agent 2018-12-13

Historical Names

Name Change Date
FAIRHAVEN CHRISTIAN HOME 1990-05-17

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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