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  5. FOX VALLEY INSURANCE AGENCY, INC.

FOX VALLEY INSURANCE AGENCY, INC.

Company Details

Entity Name: FOX VALLEY INSURANCE AGENCY, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 18 Jan 1979
Date of Dissolution: 13 Jun 2014
Company Number: CORP_51649354
File Number: 51649354
Date Status Change: 13 Jun 2014
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTH ARLINGTON PEDIATRICS, S.C. PROFIT SHARING 401(K) PLAN & TRUST 2012 362713722 2013-04-24 NORTH ARLINGTON PEDIATRICS, S.C. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8472533600
Plan sponsor’s address 1430 N. ARLINGTON HEIGHTS ROAD, ARLINGTON HEIGHTS, IL, 600044830

Signature of
Role Plan administrator
Date 2013-04-22
Name of individual signing DAVID DOBKIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-22
Name of individual signing DAVID DOBKIN
Valid signature Filed with authorized/valid electronic signature
NORTH ARLINGTON PEDIATRICS, S.C. PROFIT SHARING 401(K) PLAN & TRUST 2011 362713722 2012-08-22 NORTH ARLINGTON PEDIATRICS, S.C. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8472533600
Plan sponsor’s address 1430 N. ARLINGTON HEIGHTS ROAD, ARLINGTON HEIGHTS, IL, 600044830

Plan administrator’s name and address
Administrator’s EIN 362713722
Plan administrator’s name NORTH ARLINGTON PEDIATRICS, S.C.
Plan administrator’s address 1430 N. ARLINGTON HEIGHTS ROAD, ARLINGTON HEIGHTS, IL, 600044830
Administrator’s telephone number 8472533600

Signature of
Role Plan administrator
Date 2012-08-22
Name of individual signing DAVID DOBKIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-22
Name of individual signing DAVID DOBKIN
Valid signature Filed with authorized/valid electronic signature
NORTH ARLINGTON PEDIATRICS, S.C. PROFIT SHARING 401(K) PLAN & TRUST 2010 362713722 2011-05-31 NORTH ARLINGTON PEDIATRICS, S.C. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8472533600
Plan sponsor’s address 1430 N. ARLINGTON HEIGHTS ROAD, ARLINGTON HEIGHTS, IL, 600044830

Plan administrator’s name and address
Administrator’s EIN 362713722
Plan administrator’s name NORTH ARLINGTON PEDIATRICS, S.C.
Plan administrator’s address 1430 N. ARLINGTON HEIGHTS ROAD, ARLINGTON HEIGHTS, IL, 600044830
Administrator’s telephone number 8472533600

Signature of
Role Plan administrator
Date 2011-05-31
Name of individual signing DAVID DOBKIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-31
Name of individual signing DAVID DOBKIN
Valid signature Filed with authorized/valid electronic signature
NORTH ARLINGTON PEDIATRICS, S.C. PROFIT SHARING 401(K) PLAN & TRUST 2009 362713722 2010-08-24 NORTH ARLINGTON PEDIATRICS, S.C. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 8472533600
Plan sponsor’s address 1430 N. ARLINGTON HEIGHTS ROAD, ARLINGTON HEIGHTS, IL, 600044830

Plan administrator’s name and address
Administrator’s EIN 362713722
Plan administrator’s name NORTH ARLINGTON PEDIATRICS, S.C.
Plan administrator’s address 1430 N. ARLINGTON HEIGHTS ROAD, ARLINGTON HEIGHTS, IL, 600044830
Administrator’s telephone number 8472533600

Signature of
Role Plan administrator
Date 2010-08-24
Name of individual signing DAVID DOBKIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-24
Name of individual signing DAVID DOBKIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
RICHARD KUHN, 552 S WASHINTON ST, NAPERVILLE, 60540, DU PAGE Agent 1983-04-02

President

Name and Address Role
THOMAS L BALLEW, 7318 BLACKHAWK DR TINLEY PARK 60487 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 1000 1000000 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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