| Entity Name: | JEFFERSON STREET CLINIC, S.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 08 Jun 1970 |
| Date of Dissolution: | 12 Nov 2010 |
| Company Number: | CORP_49673957 |
| File Number: | 49673957 |
| Date Status Change: | 12 Nov 2010 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFERSON STREET CLINIC, S.C. PROFIT SHARING PLAN & TRUST | 2010 | 370920717 | 2010-11-09 | JEFFERSON STREET CLINIC, S.C. | 8 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 370920717 |
| Plan administrator’s name | JEFFERSON STREET CLINIC, S.C. |
| Plan administrator’s address | 84 LOCUST RIDGE CT, MORTON, IL, 61550 |
| Administrator’s telephone number | 3092669711 |
Signature of
| Role | Plan administrator |
| Date | 2010-11-09 |
| Name of individual signing | LARRY PATTON |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-11-09 |
| Name of individual signing | LARRY PATTON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1972-01-25 |
| Business code | 621111 |
| Sponsor’s telephone number | 3092669711 |
| Plan sponsor’s address | 84 LOCUST RIDGE CT, MORTON, IL, 61550 |
Plan administrator’s name and address
| Administrator’s EIN | 370920717 |
| Plan administrator’s name | JEFFERSON STREET CLINIC, S.C. |
| Plan administrator’s address | 84 LOCUST RIDGE CT, MORTON, IL, 61550 |
| Administrator’s telephone number | 3092669711 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-23 |
| Name of individual signing | LARRY PATTON |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-07-23 |
| Name of individual signing | LARRY PATTON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| HUSCH REGISTERED AGENT INC, 401 MAIN ST STE 1400, PEORIA, 61602, PEORIA | Agent | 2007-06-08 |
| Name and Address | Role |
|---|---|
| LARRY PATTON 107 E JEFFERSON MORTON IL 61550 | President |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMM | No data | Voting Rights | 500 | 500000 | 10 |
Date of last update: 27 Jan 2025
