| Entity Name: | CHAPKO AND SHAH MODERN DENTISTRY, P.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Goodstanding |
| Date Formed: | 29 Jun 1988 |
| Company Number: | CORP_55136726 |
| File Number: | 55136726 |
| Type of Business: | Business Corporations |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHAPKO AND SHAH MODERN DENTISTRY 401K PROFIT SHARING PLAN | 2023 | 363587191 | 2024-10-14 | CHAPKO AND SHAH MODERN DENTISTRY | 16 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-14 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-10-14 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2016-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 8155445144 |
| Plan sponsor’s address | 140 NORTH STATE STREET, BELVIDERE, IL, 61008 |
Signature of
| Role | Plan administrator |
| Date | 2023-08-28 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-08-28 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2016-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 8155445144 |
| Plan sponsor’s address | 140 NORTH STATE STREET, BELVIDERE, IL, 61008 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-26 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2022-09-26 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2016-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 8155445144 |
| Plan sponsor’s address | 140 NORTH STATE STREET, BELVIDERE, IL, 61008 |
Signature of
| Role | Plan administrator |
| Date | 2021-10-12 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2021-10-12 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2016-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 8155445144 |
| Plan sponsor’s address | 140 NORTH STATE STREET, BELVIDERE, IL, 61008 |
Signature of
| Role | Plan administrator |
| Date | 2020-07-17 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2020-07-17 |
| Name of individual signing | SHEFALI SHAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| CHARLES G POPP P.C., 215 S STATE ST, BELVIDERE, 61008, BOONE | Agent | 2002-07-19 |
| Name and Address | Role |
|---|---|
| JAMES R CHAPKO, 1965 RIVERSIDEBELVIDERE 61008 | President |
| Name | Change Date |
|---|---|
| JAMES R CHAPKO, D.D.S., P.C. | 2019-01-10 |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMM | No data | Voting Rights | 1000 | 100000 | No data |
Date of last update: 27 Jan 2025
