| Entity Name: | AMERICAN HOSPITAL SERVICE CORPORATION |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 15 Oct 1991 |
| Date of Dissolution: | 13 Mar 2020 |
| Company Number: | CORP_56569774 |
| File Number: | 56569774 |
| Type of Business: | Incorporated under the Medical Corporation Act |
| Date Status Change: | 13 Mar 2020 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LIZARD INVESTORS LLC 401 K PROFIT SHARING PLAN TRUST | 2012 | 261211976 | 2013-06-20 | LIZARD INVESTORS LLC | 6 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2013-06-20 |
| Name of individual signing | LIZARD INVESTORS LLC |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 3128037300 |
| Plan sponsor’s address | 435 N MICHIGAN AVE STE 2300, CHICAGO, IL, 60611 |
Plan administrator’s name and address
| Administrator’s EIN | 261211976 |
| Plan administrator’s name | LIZARD INVESTORS LLC |
| Plan administrator’s address | 435 N MICHIGAN AVE STE 2300, CHICAGO, IL, 60611 |
| Administrator’s telephone number | 3128037300 |
Signature of
| Role | Plan administrator |
| Date | 2012-05-16 |
| Name of individual signing | LIZARD INVESTORS LLC |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 3035873949 |
| Plan sponsor’s address | 435 N MICHIGAN AVE SUITE 2300, CHICAGO, IL, 60611 |
Plan administrator’s name and address
| Administrator’s EIN | 261211976 |
| Plan administrator’s name | LIZARD INVESTORS LLC |
| Plan administrator’s address | 435 N MICHIGAN AVE SUITE 2300, CHICAGO, IL, 60611 |
| Administrator’s telephone number | 3035873949 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-06 |
| Name of individual signing | LIZARD INVESTORS LLC |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 3035873949 |
| Plan sponsor’s address | 435 N MICHIGAN AVE SUITE 2300, CHICAGO, IL, 60611 |
Plan administrator’s name and address
| Administrator’s EIN | 261211976 |
| Plan administrator’s name | LIZARD INVESTORS LLC |
| Plan administrator’s address | 435 N MICHIGAN AVE SUITE 2300, CHICAGO, IL, 60611 |
| Administrator’s telephone number | 3035873949 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-08 |
| Name of individual signing | LIZARD INVESTORS LLC |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| HENRYK ROZTOCZYNSKI, 6157 W BELMONT AVE, CHICAGO, 60634, COOK-NOT IN CITY OF CHICAGO | Agent | 1991-10-15 |
| Name and Address | Role |
|---|---|
| HENRYK ROZTOCZYNSKI, 6157 W BELMONT, CHICAGO 60634 | President |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMM | No data | Voting Rights | 1000 | 1000000 | No data |
Date of last update: 27 Jan 2025
