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  5. URBANA ASSEMBLY OF GOD, INC.

URBANA ASSEMBLY OF GOD, INC.

Company Details

Entity Name: URBANA ASSEMBLY OF GOD, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 30 Mar 1994
Company Number: CORP_57742968
File Number: 57742968
Type of Business: Religious
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
NC37E5NJVZT5 2023-03-09 1029 N 8TH ST, VANDALIA, IL, 62471, 1238, USA 1029 N 8TH STREET, VANDALIA, IL, 62471, USA

Business Information
Doing Business As (AFF: FAYETTE COUNTY HOSPITAL )
Division Name BRIAN W DOSSETT MD LTD
Division Number BRIAN W DO
Congressional District 15
State/Country of Incorporation IL, USA
Activation Date 2022-02-09
Initial Registration Date 2021-04-08
Entity Start Date 1990-08-06
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 621111

Points of Contacts
Electronic Business
Title PRIMARY POC
Name SHERRIE DEUTSCH
Address 1029 N 8TH STREET, VANDALIA, IL, 62471, USA
Government Business
Title PRIMARY POC
Name SHERRIE DEUTSCH
Address 1029 N 8TH STREET, VANDALIA, IL, 62471, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BRIAN W. DOSSETT, M.D., LTD PROFIT SHARING PLAN 2012 371264470 2013-07-23 BRIAN W. DOSSETT, M.D., LTD 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6182832894
Plan sponsor’s address 1029 NORTH EIGHTH ST, VANDALIA, IL, 62471

Signature of
Role Plan administrator
Date 2013-07-15
Name of individual signing BRIAN W. DOSSETT
Valid signature Filed with authorized/valid electronic signature
BRIAN W. DOSSETT, M.D., LTD PROFIT SHARING PLAN 2011 371264470 2012-08-17 BRIAN W. DOSSETT, M.D., LTD 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6182832894
Plan sponsor’s address 1029 NORTH EIGHTH ST, VANDALIA, IL, 62471

Plan administrator’s name and address
Administrator’s EIN 371264470
Plan administrator’s name BRIAN W. DOSSETT, M.D., LTD
Plan administrator’s address 1029 NORTH EIGHTH ST, VANDALIA, IL, 62471
Administrator’s telephone number 6182832894

Signature of
Role Plan administrator
Date 2012-08-17
Name of individual signing BRIAN W. DOSSETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-17
Name of individual signing BRIAN W. DOSSETT
Valid signature Filed with authorized/valid electronic signature
BRIAN W. DOSSETT, M.D., LTD PROFIT SHARING PLAN 2010 371264470 2011-07-13 BRIAN W. DOSSETT, M.D., LTD 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6182832894
Plan sponsor’s address 1029 NORTH EIGHTH ST, VANDALIA, IL, 62471

Plan administrator’s name and address
Administrator’s EIN 371264470
Plan administrator’s name BRIAN W. DOSSETT, M.D., LTD
Plan administrator’s address 1029 NORTH EIGHTH ST, VANDALIA, IL, 62471
Administrator’s telephone number 6182832894

Signature of
Role Plan administrator
Date 2011-07-13
Name of individual signing BRIAN W DOSSETT
Valid signature Filed with authorized/valid electronic signature
BRIAN W. DOSSETT, M.D., LTD PROFIT SHARING PLAN 2009 371264470 2010-06-23 BRIAN W. DOSSETT, M.D., LTD 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6182832894
Plan sponsor’s address 1029 NORTH EIGHTH ST, VANDALIA, IL, 62471

Plan administrator’s name and address
Administrator’s EIN 371264470
Plan administrator’s name BRIAN W. DOSSETT, M.D., LTD
Plan administrator’s address 1029 NORTH EIGHTH ST, VANDALIA, IL, 62471
Administrator’s telephone number 6182832894

Signature of
Role Plan administrator
Date 2010-06-23
Name of individual signing BRIAN W. DOSSETT
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
RICHARD J SPINDLER, 2502 S RACE ST, URBANA, 61801, CHAMPAIGN Agent 2017-03-10

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
STONE CREEK CHURCH NFP Assume Name 2007-06-19 No data No data 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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