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FORM GRAPHICS, INC.

Company Details

Entity Name: FORM GRAPHICS, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 08 Sep 1971
Date of Dissolution: 09 Feb 2018
Company Number: CORP_49888279
File Number: 49888279
Date Status Change: 09 Feb 2018
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FORM GRAPHICS, INC. 401(K) PLAN 2015 362729155 2017-03-24 FORM GRAPHICS, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-08-01
Business code 541400
Sponsor’s telephone number 6302353726
Plan sponsor’s address 516 NO. MALDEN, LAGRANGE PARK, IL, 60526

Signature of

Role Plan administrator
Date 2017-03-14
Name of individual signing JIM KEEFER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-03-14
Name of individual signing JIM KEEFER
Valid signature Filed with authorized/valid electronic signature
FORM GRAPHICS, INC. 401(K) PLAN 2014 362729155 2016-02-29 FORM GRAPHICS, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-08-01
Business code 541400
Sponsor’s telephone number 6308932800
Plan sponsor’s address 516 NO. MALDEN, LAGRANGE PARK, IL, 60526

Signature of

Role Plan administrator
Date 2016-02-27
Name of individual signing JIM KEEFER
Valid signature Filed with authorized/valid electronic signature
FORM GRAPHICS, INC. 401(K) PLAN 2013 362729155 2015-06-25 FORM GRAPHICS, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-08-01
Business code 541400
Sponsor’s telephone number 6302353726
Plan sponsor’s address 516 NO. MALDEN, LAGRANGE PARK, IL, 60526

Signature of

Role Plan administrator
Date 2015-06-23
Name of individual signing JIM KEEFER
Valid signature Filed with authorized/valid electronic signature
FORM GRAPHICS, INC. 401(K) PLAN 2012 362729155 2015-06-25 FORM GRAPHICS, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-08-01
Business code 541400
Sponsor’s telephone number 6302353726
Plan sponsor’s address 516 NO. MALDEN, LAGRANGE PARK, IL, 60526

Signature of

Role Plan administrator
Date 2015-06-23
Name of individual signing JIM KEEFER
Valid signature Filed with authorized/valid electronic signature
FORM GRAPHICS, INC. 401(K) PLAN 2011 362729155 2015-06-25 FORM GRAPHICS, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-08-01
Business code 541400
Sponsor’s telephone number 6302353726
Plan sponsor’s address 516 NO. MALDEN, LAGRANGE PARK, IL, 60526

Plan administrator’s name and address

Administrator’s EIN 362729155
Plan administrator’s name FORM GRAPHICS, INC.
Plan administrator’s address 516 NO. MALDEN, LAGRANGE PARK, IL, 60526
Administrator’s telephone number 6302353726

Signature of

Role Plan administrator
Date 2015-06-23
Name of individual signing JIM KEEFER
Valid signature Filed with authorized/valid electronic signature
FORM GRAPHICS, INC. 401(K) PLAN 2011 362729155 2015-06-25 FORM GRAPHICS, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-08-01
Business code 541400
Sponsor’s telephone number 6302353726
Plan sponsor’s address 516 NO. MALDEN, LAGRANGE PARK, IL, 60526

Plan administrator’s name and address

Administrator’s EIN 362729155
Plan administrator’s name FORM GRAPHICS, INC.
Plan administrator’s address 516 NO. MALDEN, LAGRANGE PARK, IL, 60526
Administrator’s telephone number 6302353726

Signature of

Role Plan administrator
Date 2015-06-23
Name of individual signing JIM KEEFER
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JAMES M KEEFER, 905 W HILLGROVE AVE PO BOX 284, LA GRANGE, 60525, DU PAGE Agent 2014-09-04

President

Name and Address Role
JAMES KEEFER PO BOX 284 LAGRANGE IL 60525 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 1000 100000 No data

Date of last update: 30 Jan 2025

Sources: Illinois Office of the Secretary of State