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DEROO FUNERAL HOME, LTD.

DEROO FUNERAL HOME, LTD.

Company Details

Entity Name:	DEROO FUNERAL HOME, LTD.
Jurisdiction:	Illinois
Entity Type:	Corporation - Domestic BCA
Status:	Goodstanding
Date Formed:	16 Aug 1982
Company Number:	CORP_52818095
File Number:	52818095
Type of Business:	All Inclusive Purpose
Place of Formation:	ILLINOIS

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

DEROO FUNERAL HOME, LTD. EMPLOYEE SAVINGS PLAN

2012

363191234

2013-07-17

DEROO FUNERAL HOME, LTD.

2

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1992-01-01
Business code	541990
Sponsor’s telephone number	3097625735
Plan sponsor’s address	1611 7TH STREET, MOLINE, IL, 61265

Signature of

Role	Plan administrator
Date	2013-07-17
Name of individual signing	KEVIN E. DEROO
Valid signature	Filed with authorized/valid electronic signature

DEROO FUNERAL HOME, LTD. EMPLOYEE SAVINGS PLAN

2011

363191234

2012-10-10

DEROO FUNERAL HOME, LTD.

3

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1992-01-01
Business code	541990
Sponsor’s telephone number	3097625735
Plan sponsor’s address	1611 7TH STREET, MOLINE, IL, 61265

Plan administrator’s name and address

Administrator’s EIN	363191234
Plan administrator’s name	DEROO FUNERAL HOME, LTD.
Plan administrator’s address	1611 7TH STREET, MOLINE, IL, 61265
Administrator’s telephone number	3097625735

Signature of

Role	Plan administrator
Date	2012-10-10
Name of individual signing	KEVIN E. DEROO
Valid signature	Filed with authorized/valid electronic signature

DEROO FUNERAL HOME, LTD EMPLOYEE SAVINGS PLAN

2010

363191234

2011-06-23

DEROO FUNERAL HOME, LTD

3

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1992-01-01
Business code	541990
Sponsor’s telephone number	3097625735
Plan sponsor’s address	1611 7TH STREET, MOLINE, IL, 61265

Plan administrator’s name and address

Administrator’s EIN	363191234
Plan administrator’s name	DEROO FUNERAL HOME, LTD
Plan administrator’s address	1611 7TH STREET, MOLINE, IL, 61265
Administrator’s telephone number	3097625735

Signature of

Role	Plan administrator
Date	2011-06-23
Name of individual signing	KAREN PECKENSCHNEIDER
Valid signature	Filed with authorized/valid electronic signature

DEROO FUNERAL HOME, LTD EMPLOYEE SAVINGS PLAN

2009

363191234

2010-07-07

DEROO FUNERAL HOME, LTD

3

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1992-01-01
Business code	541990
Sponsor’s telephone number	3097625735
Plan sponsor’s address	1611 7TH STREET, MOLINE, IL, 61265

Plan administrator’s name and address

Administrator’s EIN	363191234
Plan administrator’s name	DEROO FUNERAL HOME, LTD
Plan administrator’s address	1611 7TH STREET, MOLINE, IL, 61265
Administrator’s telephone number	3097625735

Signature of

Role	Plan administrator
Date	2010-07-07
Name of individual signing	NANCY MANARY
Valid signature	Filed with authorized/valid electronic signature

Agent

Name and Address	Role	Appointment Date
DANIEL CHURCHILL, 1610 FIFTH AVE, MOLINE, 61265, ROCK ISLAND	Agent	2008-02-04

President

Name and Address	Role
KEVIN E DEROO, 1811 15TH ST PLACE MOLINE IL 61265	President

Secretary

Name and Address	Role
JANIS E DEROO	Secretary

Shares

Class	Series	Voting Rights	Authorized Shares	Issued Shares	Par Value
COMM	A	Voting Rights	500	500000	No data
COMM	B	No Voting Rights	5000	5000000	No data

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State