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  5. KIRK P PAVLETIC, O.D., P.C.

KIRK P PAVLETIC, O.D., P.C.

Company Details

Entity Name: KIRK P PAVLETIC, O.D., P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 08 Apr 1992
Company Number: CORP_56794522
File Number: 56794522
Type of Business: Incorporated under the Professional Service Corporation Act
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KIRK PAVLETIC 401(K) PLAN 2021 363824109 2022-03-10 KIRK P. PAVLETIC, O.D. P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7086914013
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2022-03-10
Name of individual signing KIRK PAVLETIC
Valid signature Filed with authorized/valid electronic signature
KIRK PAVLETIC 401(K) PLAN 2021 363824109 2022-09-23 KIRK P. PAVLETIC, O.D. P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7086914013
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2022-09-23
Name of individual signing KIRK PAVLETIC
Valid signature Filed with authorized/valid electronic signature
KIRK PAVLETIC 401(K) PLAN 2020 363824109 2021-06-05 KIRK P. PAVLETIC, O.D. P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7086914013
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2021-06-05
Name of individual signing KIRK PAVLETIC
Valid signature Filed with authorized/valid electronic signature
KIRK PAVLETIC 401(K) PLAN 2019 363824109 2020-07-29 KIRK P. PAVLETIC, O.D. P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7086914013
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2020-07-29
Name of individual signing KIRK PAVLETIC
Valid signature Filed with authorized/valid electronic signature
KIRK PAVLETIC 401(K) PLAN 2018 363824109 2019-06-24 KIRK P. PAVLETIC, O.D. P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7084037711
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2019-06-24
Name of individual signing KIM WEYNETH
Valid signature Filed with authorized/valid electronic signature
KIRK PAVLETIC 401(K) PLAN 2017 363824109 2018-06-22 KIRK P. PAVLETIC, O.D. P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7084037711
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2018-06-22
Name of individual signing KIM PAVLETIC
Valid signature Filed with authorized/valid electronic signature
KIRK PAVLETIC 401(K) PLAN 2016 363824109 2017-05-26 KIRK P. PAVLETIC, O.D. P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7084037711
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2017-05-26
Name of individual signing KIRK PAVLETIC
Valid signature Filed with authorized/valid electronic signature
KIRK PAVLETIC 401(K) PLAN 2015 363824109 2016-05-21 KIRK P. PAVLETIC, O.D. P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7084037711
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2016-05-21
Name of individual signing KIRK PAVLETIC
Valid signature Filed with authorized/valid electronic signature
KIRK PAVLETIC 401(K) PLAN 2014 363824109 2015-06-21 KIRK P. PAVLETIC O.D. P.C. 3
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7084037711
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2015-06-20
Name of individual signing KIRK PAVLETIC
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-20
Name of individual signing KIRK PAVLETIC
Valid signature Filed with authorized/valid electronic signature
KIRK PAVLETIC 401(K) PLAN 2013 363824109 2014-07-02 KIRK P. PAVLETIC O.D. P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621320
Sponsor’s telephone number 7084037711
Plan sponsor’s address 10739 WEST 159TH STREET, ORLAND PARK, IL, 60467

Signature of
Role Plan administrator
Date 2014-07-02
Name of individual signing KIRKPAVLETIC
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
KIRK P PAVLETIC, 11115 GLENBROOK LN, INDIAN HEAD PK, 60525, COOK-NOT IN CITY OF CHICAGO Agent 2006-03-20

President

Name and Address Role
KIRK P PAVLETIC, 11115 GLENBROOK LANE INDIANHEAD PARK 60525 President

Secretary

Name and Address Role
KIRK P PAVLETIC Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 100 100000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State

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