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THE BOUTIQUE BY HIRSTEIN, LTD.

Company Details

Entity Name: THE BOUTIQUE BY HIRSTEIN, LTD.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 18 Jul 1986
Date of Dissolution: 01 Dec 2001
Company Number: CORP_54318855
File Number: 54318855
Type of Business: Wholesale and Retail
Date Status Change: 01 Dec 2001
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROSELAND DENTAL CLINIC LLC 401K PLAN 2012 262203570 2013-07-09 ROSELAND DENTAL CLINIC LLC 2
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 7739953024
Plan sponsor’s address 134 W 111TH ST, CHICAGO, IL, 60628

Signature of

Role Plan administrator
Date 2013-07-09
Name of individual signing DR AMIT SAPARIA
Valid signature Filed with authorized/valid electronic signature
ROSELAND DENTAL CLINIC LLC 401K PLAN 2011 262203570 2012-09-28 ROSELAND DENTAL CLINIC LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 7739953024
Plan sponsor’s address 134 W 111TH ST, CHICAGO, IL, 60628

Plan administrator’s name and address

Administrator’s EIN 262203570
Plan administrator’s name ROSELAND DENTAL CLINIC LLC
Plan administrator’s address 134 W 111TH ST, CHICAGO, IL, 60628
Administrator’s telephone number 7739953024

Signature of

Role Plan administrator
Date 2012-09-28
Name of individual signing DR AMIT SAPARIA
Valid signature Filed with authorized/valid electronic signature
ROSELAND DENTAL CLINIC LLC 401K PLAN 2011 262203570 2012-06-25 ROSELAND DENTAL CLINIC LLC 2
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 7739953024
Plan sponsor’s address 134 W 111TH ST, CHICAGO, IL, 60628

Plan administrator’s name and address

Administrator’s EIN 262203570
Plan administrator’s name ROSELAND DENTAL CLINIC LLC
Plan administrator’s address 134 W 111TH ST, CHICAGO, IL, 60628
Administrator’s telephone number 7739953024

Signature of

Role Plan administrator
Date 2012-06-25
Name of individual signing DR AMIT SAPARIA
Valid signature Filed with authorized/valid electronic signature
ROSELAND DENTAL CLINIC LLC 401K PLAN 2010 262203570 2011-09-28 ROSELAND DENTAL CLINIC LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 7739953024
Plan sponsor’s address 134 W 111TH ST, CHICAGO, IL, 60628

Plan administrator’s name and address

Administrator’s EIN 262203570
Plan administrator’s name ROSELAND DENTAL CLINIC LLC
Plan administrator’s address 134 W 111TH ST, CHICAGO, IL, 60628
Administrator’s telephone number 7739953024

Signature of

Role Plan administrator
Date 2011-09-28
Name of individual signing DR AMIT SAPARIA
Valid signature Filed with authorized/valid electronic signature
ROSELAND DENTAL CLINIC LLC 401K PLAN 2010 262203570 2011-09-23 ROSELAND DENTAL CLINIC LLC 2
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 7739953024
Plan sponsor’s address 134 W 111TH ST, CHICAGO, IL, 60628

Plan administrator’s name and address

Administrator’s EIN 262203570
Plan administrator’s name ROSELAND DENTAL CLINIC LLC
Plan administrator’s address 134 W 111TH ST, CHICAGO, IL, 60628
Administrator’s telephone number 7739953024

Signature of

Role Plan administrator
Date 2011-09-23
Name of individual signing DR AMIT SAPARIA
Valid signature Filed with authorized/valid electronic signature
ROSELAND DENTAL CLINIC LLC 401K PLAN 2009 262203570 2010-10-12 ROSELAND DENTAL CLINIC LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621210
Sponsor’s telephone number 7739953024
Plan sponsor’s address 134 W 111TH ST, CHICAGO, IL, 60628

Plan administrator’s name and address

Administrator’s EIN 262203570
Plan administrator’s name ROSELAND DENTAL CLINIC LLC
Plan administrator’s address 134 W 111TH ST, CHICAGO, IL, 60628
Administrator’s telephone number 7739953024

Signature of

Role Plan administrator
Date 2010-10-12
Name of individual signing FRANK HARRISON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MICHAEL L BUSH, 225 N MAIN STREET, MORTON, 61550, TAZEWELL Agent 1986-07-18

President

Name and Address Role
C HIRSTEIN, 4339 COMMERCIAL WAY SPRING HILL FLORIDA 34607 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 50000 25000000 No data

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State