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  5. ANTOINETTE M. PETTITT, D.D.S., LTD.

ANTOINETTE M. PETTITT, D.D.S., LTD.

Company Details

Entity Name: ANTOINETTE M. PETTITT, D.D.S., LTD.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 21 Jun 1993
Company Number: CORP_57360313
File Number: 57360313
Type of Business: Incorporated under the Medical Corporation Act
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANTOINETTE M PETTITT DDS LTD FLEXIBLE 401(K) PROFIT-SHARING PLAN 2016 363885575 2017-07-11 ANTOINETTE M. PETTITT, D.D.S., LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-11-01
Business code 621210
Sponsor’s telephone number 7739944433
Plan sponsor’s address 457 E 87TH STREET, CHICAGO, IL, 60619

Signature of
Role Plan administrator
Date 2017-07-11
Name of individual signing ANTOINETTE M. PETTITT, D.D.S.
Valid signature Filed with authorized/valid electronic signature
ANTOINETTE M PETTITT DDS LTD FLEXIBLE 401(K) PROFIT-SHARING PLAN 2015 363885575 2016-07-28 ANTOINETTE M. PETTITT, D.D.S., LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-11-01
Business code 621210
Plan sponsor’s address 457 E 87TH STREET, CHICAGO, IL, 60619

Signature of
Role Plan administrator
Date 2016-07-28
Name of individual signing ANTOINETTE M. PETTITT, D.D.S.
Valid signature Filed with authorized/valid electronic signature
ANTOINETTE M PETTITT DDS LTD FLEXIBLE 401(K) PROFIT-SHARING PLAN 2014 363885575 2015-07-16 ANTOINETTE M. PETTITT, D.D.S., LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-11-01
Business code 621210
Plan sponsor’s address 457 E 87TH STREET, CHICAGO, IL, 60619

Signature of
Role Plan administrator
Date 2015-07-16
Name of individual signing ANTOINETTE M. PETTITT, D.D.S.
Valid signature Filed with authorized/valid electronic signature
ANTOINETTE M PETTITT DDS LTD FLEXIBLE 401(K) PROFIT-SHARING PLAN 2013 363885575 2014-08-25 ANTOINETTE M. PETTITT, D.D.S., LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-11-01
Business code 621210
Plan sponsor’s address 457 E 87TH STREET, CHICAGO, IL, 60619

Signature of
Role Plan administrator
Date 2014-08-25
Name of individual signing ANTOINETTE M. PETTITT, D.D.S.
Valid signature Filed with authorized/valid electronic signature
ANTOINETTE M PETTITT DDS LTD FLEXIBLE 401(K) PROFIT SHARING PLAN 2012 363885575 2013-10-03 ANTOINETTE M. PETTITT, D.D.S., LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-11-01
Business code 621210
Plan sponsor’s address 457 E. 87TH STREET, CHICAGO, IL, 60619

Signature of
Role Plan administrator
Date 2013-09-23
Name of individual signing ANTOINETTE PETTITT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-23
Name of individual signing ANTOINETTE PETTITT
Valid signature Filed with authorized/valid electronic signature
ANTOINETTE M PETTITT DDS LTD FLEXIBLE 401(K) PROFIT SHARING PLAN 2011 363885575 2012-07-17 ANTOINETTE M. PETTITT, D.D.S., LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-11-01
Business code 621210
Plan sponsor’s address 457 E. 87TH STREET, CHICAGO, IL, 60619

Plan administrator’s name and address
Administrator’s EIN 363885575
Plan administrator’s name ANTOINETTE M. PETTITT, D.D.S., LTD.
Plan administrator’s address 457 E. 87TH STREET, CHICAGO, IL, 60619

Signature of
Role Plan administrator
Date 2012-07-17
Name of individual signing ANTOINETTE PETTITT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-17
Name of individual signing ANTOINETTE PETTITT
Valid signature Filed with authorized/valid electronic signature
ANTOINETTE M PETTITT DDS LTD FLEXIBLE 401(K) PROFIT SHARING PLAN 2010 363885575 2011-07-13 ANTOINETTE M. PETTITT, D.D.S., LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-11-01
Business code 621210
Plan sponsor’s address 457 E. 87TH STREET, CHICAGO, IL, 60619

Plan administrator’s name and address
Administrator’s EIN 363885575
Plan administrator’s name ANTOINETTE M. PETTITT, D.D.S., LTD.
Plan administrator’s address 457 E. 87TH STREET, CHICAGO, IL, 60619

Signature of
Role Plan administrator
Date 2011-06-13
Name of individual signing ANTOINETTE PETTITT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-06-13
Name of individual signing ANTOINETTE PETTITT
Valid signature Filed with authorized/valid electronic signature
ANTOINETTE M PETTITT DDS LTD FLEXIBLE 401K PROFIT SHARING PLAN 2009 363885575 2010-07-15 ANTOINETTE M. PETTITT, D.D.S., LTD. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-11-01
Business code 621210
Plan sponsor’s mailing address 457 E. 87TH STREET, CHICAGO, IL, 60619
Plan sponsor’s address 457 E. 87TH STREET, CHICAGO, IL, 60619

Plan administrator’s name and address
Administrator’s EIN 363885575
Plan administrator’s name ANTOINETTE M. PETTITT, D.D.S., LTD.
Plan administrator’s address 457 E. 87TH STREET, CHICAGO, IL, 60619

Number of participants as of the end of the plan year
Active participants 3
Number of participants with account balances as of the end of the plan year 3

Signature of
Role Plan administrator
Date 2010-06-01
Name of individual signing ANTOINETTE PETTITT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-06-01
Name of individual signing ANTOINETTE PETTITT
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ANTOINETTE M PETTITT, 155 HARBOR DR, CHCIAGO, 60601, COOK-NOT IN CITY OF CHICAGO Agent 2021-05-11

President

Name and Address Role
ANTOINETTE M PETTITT, 155 HARBOR DR 411 CHICAGO 60601 President

Secretary

Name and Address Role
ANTOINETTE M PETTITT, 155 HARBOR DR 411 CHICAGO 60601 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: 27 Jan 2025

Sources: Illinois Office of the Secretary of State

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