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  5. CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION

CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION

Company Details

Entity Name: CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 03 Dec 1971
Company Number: CORP_49933282
File Number: 49933282
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
G9BRJMNQNC46 2025-02-07 707 MCADAM DR, TAYLORVILLE, IL, 62568, 2300, USA PO BOX 438, TAYLORVILLE, IL, 62568, 2300, USA

Business Information
Doing Business As CCMHA
Congressional District 15
State/Country of Incorporation IL, USA
Activation Date 2024-02-12
Initial Registration Date 2010-06-04
Entity Start Date 1971-07-01
Fiscal Year End Close Date Jun 30

Service Classifications
NAICS Codes 624310, 813410
Product and Service Codes Y1PB

Points of Contacts
Electronic Business
Title PRIMARY POC
Name BRENT M DEMICHAEL
Address 707 MCADAM DRIVE, TAYLORVILLE, IL, 62568, USA
Title ALTERNATE POC
Name BRENT M DEMICHAEL
Address 707 MCADAM DRIVE, TAYLORVILLE, IL, 62568, USA
Government Business
Title PRIMARY POC
Name BRENT M DEMICHAEL
Address 707 MCADAM DRIVE, TAYLORVILLE, IL, 62568, 2300, USA
Title ALTERNATE POC
Name BRENT M DEMICHAEL
Address 707 MCADAM DRIVE, TAYLORVILLE, IL, 62568, USA
Past Performance
Title PRIMARY POC
Name BRENT M DEMICHAEL
Address 707 MCADAM DRIVE, TAYLORVILLE, IL, 62568, USA
Title ALTERNATE POC
Name BRENT M DEMICHAEL
Address 707 MCADAM DRIVE, TAYLORVILLE, IL, 62568, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE BENEFIT PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2022 370951440 2023-06-15 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-12-01
Business code 813000
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, 707 MCADAM DR, TAYLORVILLE, IL, 625682300

Signature of
Role Plan administrator
Date 2023-06-15
Name of individual signing TONYA HUGHES
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2022 370951440 2023-06-15 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 813000
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, 707 MCADAM DR, TAYLORVILLE, IL, 625682300

Signature of
Role Plan administrator
Date 2023-06-15
Name of individual signing TONYA HUGHES
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2021 370951440 2022-04-01 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-12-01
Business code 813000
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, TAYLORVILLE, IL, 625680438

Signature of
Role Plan administrator
Date 2022-04-01
Name of individual signing TONYA HUGHES
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2021 370951440 2022-04-01 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 813000
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, TAYLORVILLE, IL, 625680438

Signature of
Role Plan administrator
Date 2022-04-01
Name of individual signing TONYA HUGHES
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2020 370951440 2021-07-22 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-12-01
Business code 813000
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, TAYLORVILLE, IL, 625680438

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing TONYA HUGHES
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2020 370951440 2021-07-22 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 813000
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, TAYLORVILLE, IL, 625680438

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing TONYA HUGHES
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2019 370951440 2020-07-27 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-12-01
Business code 813000
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, TAYLORVILLE, IL, 625680438

Signature of
Role Plan administrator
Date 2020-07-27
Name of individual signing VERNALEE MCKEE
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2019 370951440 2020-07-27 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 813000
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, TAYLORVILLE, IL, 625680438

Signature of
Role Plan administrator
Date 2020-07-27
Name of individual signing VERNALEE MCKEE
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2018 370951440 2019-10-10 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 621420
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, TAYLORVILLE, IL, 625680438

Signature of
Role Plan administrator
Date 2019-10-10
Name of individual signing VERNALEE MCKEE
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 2018 370951440 2019-10-10 CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-12-01
Business code 621420
Sponsor’s telephone number 2178249675
Plan sponsor’s address PO BOX 438, TAYLORVILLE, IL, 625680438

Signature of
Role Plan administrator
Date 2019-10-10
Name of individual signing VERNALEE MCKEE
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
BRENT M. DEMICHAEL, 707 MCADAM DR, TAYLORVILLE, 62568, CHRISTIAN Agent 2024-11-21

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
CENTRAL ILLINOIS DEVELOPMENTAL SERVICES NFP Assume Name 2024-07-02 No data No data No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State

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