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  5. DOLL FURNITURE COMPANY

DOLL FURNITURE COMPANY

Company Details

Entity Name: DOLL FURNITURE COMPANY
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 19 Sep 1967
Company Number: CORP_48034560
File Number: 48034560
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROCKFORD SURGICAL SERVICE, S.C. EMPLOYEE SAVINGS AND PROFIT SHARING PLAN 2011 362615103 2012-10-13 ROCKFORD SURGICAL SERVICE, S.C. 57
Three-digit plan number (PN) 001
Effective date of plan 1969-01-01
Business code 621111
Sponsor’s telephone number 8153977900
Plan sponsor’s address 5668 EAST STATE STREET, ROCKFORD, IL, 61108

Plan administrator’s name and address
Administrator’s EIN 362615103
Plan administrator’s name ROCKFORD SURGICAL SERVICE, S.C.
Plan administrator’s address 5668 EAST STATE STREET, ROCKFORD, IL, 61108
Administrator’s telephone number 8153977900

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing DUANE ZIMMERMAN
Valid signature Filed with authorized/valid electronic signature
ROCKFORD SURGICAL SERVICE, S.C. DEFINED BENEFIT PENSION PLAN 2010 362615103 2011-12-06 ROCKFORD SURGICAL SERVICE, S.C. 54
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 8153977900
Plan sponsor’s address 5668 EAST STATE STREET, ROCKFORD, IL, 611082464

Plan administrator’s name and address
Administrator’s EIN 362615103
Plan administrator’s name ROCKFORD SURGICAL SERVICE, S.C.
Plan administrator’s address 5668 EAST STATE STREET, ROCKFORD, IL, 611082464
Administrator’s telephone number 8153977900

Signature of
Role Plan administrator
Date 2011-12-06
Name of individual signing LARRY BUTCHER PREPARER
Valid signature Filed with authorized/valid electronic signature
ROCKFORD SURGICAL SERVICE, S.C. EMPLOYEE SAVINGS AND PROFIT SHARING PLAN 2010 362615103 2011-10-14 ROCKFORD SURGICAL SERVICE, S.C. 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1969-01-01
Business code 621111
Sponsor’s telephone number 8153977900
Plan sponsor’s address 5668 EAST STATE STREET, ROCKFORD, IL, 61108

Plan administrator’s name and address
Administrator’s EIN 362615103
Plan administrator’s name ROCKFORD SURGICAL SERVICE, S.C.
Plan administrator’s address 5668 EAST STATE STREET, ROCKFORD, IL, 61108
Administrator’s telephone number 8153977900

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing DUANE ZIMMERMAN
Valid signature Filed with authorized/valid electronic signature
ROCKFORD SURGICAL SERVICE, S.C. DEFINED BENEFIT PENSION PLAN 2010 362615103 2011-08-09 ROCKFORD SURGICAL SERVICE, S.C. 58
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 8153977900
Plan sponsor’s address 5668 EAST STATE STREET, ROCKFORD, IL, 611082464

Plan administrator’s name and address
Administrator’s EIN 362615103
Plan administrator’s name ROCKFORD SURGICAL SERVICE, S.C.
Plan administrator’s address 5668 EAST STATE STREET, ROCKFORD, IL, 611082464
Administrator’s telephone number 8153977900

Signature of
Role Plan administrator
Date 2011-08-09
Name of individual signing LARRY BUTCHER
Valid signature Filed with authorized/valid electronic signature
ROCKFORD SURGICAL SERVICE, S.C. DEFINED BENEFIT PENSION PLAN 2009 362615103 2010-08-16 ROCKFORD SURGICAL SERVICE, S.C. 63
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 8153977900
Plan sponsor’s address 5668 EAST STATE STREET, ROCKFORD, IL, 611082464

Plan administrator’s name and address
Administrator’s EIN 362615103
Plan administrator’s name ROCKFORD SURGICAL SERVICE, S.C.
Plan administrator’s address 5668 EAST STATE STREET, ROCKFORD, IL, 611082464
Administrator’s telephone number 8153977900

Signature of
Role Plan administrator
Date 2010-08-16
Name of individual signing LARRY BUTCHER
Valid signature Filed with authorized/valid electronic signature
ROCKFORD SURGICAL SERVICE, S.C. EMPLOYEE SAVINGS AND PROFIT SHARING PLAN 2009 362615103 2010-10-12 ROCKFORD SURGICAL SERVICE, S.C. 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1969-01-01
Business code 621111
Sponsor’s telephone number 8153977900
Plan sponsor’s address 5668 EAST STATE STREET, ROCKFORD, IL, 61107

Plan administrator’s name and address
Administrator’s EIN 362615103
Plan administrator’s name ROCKFORD SURGICAL SERVICE, S.C.
Plan administrator’s address 5668 EAST STATE STREET, ROCKFORD, IL, 61107
Administrator’s telephone number 8153977900

Signature of
Role Plan administrator
Date 2010-10-12
Name of individual signing DUANE ZIMMERMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
DAVID SHUTT, 400 NORTH BEECH, NORMAL, 61761, MC LEAN Agent 1984-08-21

President

Name and Address Role
DAVID SHUTT, 19464 LAKESIDE LNBLOOMINGTON 61705 President

Secretary

Name and Address Role
JAMES SHUTT, 309 W MONROE PO BOX 214 TOWANDA 61776 Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 1000 300000 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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