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  5. RAJENDRA R. SHROFF, M.D., S.C.

RAJENDRA R. SHROFF, M.D., S.C.

Company Details

Entity Name: RAJENDRA R. SHROFF, M.D., S.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 07 Apr 1994
Company Number: CORP_57760605
File Number: 57760605
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
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2017 371323331 2018-08-09 RAJENDRA R. SHROFF, M.D., S.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2017 371323331 2018-07-26 RAJENDRA R. SHROFF, M.D., S.C. 5
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2016 371323331 2017-09-09 RAJENDRA R. SHROFF, M.D., S.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2015 371323331 2016-09-23 RAJENDRA R. SHROFF, M.D., S.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801

Signature of
Role Plan administrator
Date 2016-09-15
Name of individual signing RITA KALRA
Valid signature Filed with authorized/valid electronic signature
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2014 371323331 2015-10-14 RAJENDRA R. SHROFF, M.D., S.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing RITA KALRA
Valid signature Filed with authorized/valid electronic signature
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2013 371323331 2014-10-06 RAJENDRA R. SHROFF, M.D., S.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801

Signature of
Role Plan administrator
Date 2014-10-06
Name of individual signing RITA KALRA
Valid signature Filed with authorized/valid electronic signature
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2012 371323331 2013-10-14 RAJENDRA R. SHROFF, M.D., S.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing RITA KALRA
Valid signature Filed with authorized/valid electronic signature
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2011 371323331 2012-09-19 RAJENDRA R. SHROFF, M.D., S.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801

Plan administrator’s name and address
Administrator’s EIN 371323331
Plan administrator’s name RAJENDRA R. SHROFF, M.D., S.C.
Plan administrator’s address P. O. BOX 185, CENTRALIA, IL, 62801
Administrator’s telephone number 6185325700

Signature of
Role Plan administrator
Date 2012-09-17
Name of individual signing RITA KALRA
Valid signature Filed with authorized/valid electronic signature
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2010 371323331 2011-10-07 RAJENDRA R. SHROFF, M.D., S.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801

Plan administrator’s name and address
Administrator’s EIN 371323331
Plan administrator’s name RAJENDRA R. SHROFF, M.D., S.C.
Plan administrator’s address P. O. BOX 185, CENTRALIA, IL, 62801
Administrator’s telephone number 6185325700

Signature of
Role Plan administrator
Date 2011-10-06
Name of individual signing RITA KALRA
Valid signature Filed with authorized/valid electronic signature
RAJENDRA R. SHROFF, M.D., S.C. 401(K) PROFIT SHARING PLAN 2009 371323331 2010-09-22 RAJENDRA R. SHROFF, M.D., S.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6185325700
Plan sponsor’s address P. O. BOX 185, CENTRALIA, IL, 62801

Plan administrator’s name and address
Administrator’s EIN 371323331
Plan administrator’s name RAJENDRA R. SHROFF, M.D., S.C.
Plan administrator’s address P. O. BOX 185, CENTRALIA, IL, 62801
Administrator’s telephone number 6185325700

Signature of
Role Plan administrator
Date 2010-09-22
Name of individual signing RITA KALRA
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
RAJENDRA R SHROFF, 11 CLEAR LAKE DR, CENTRALIA, 62501, MARION Agent 2004-09-02

President

Name and Address Role
RAJENDRA R SHROFF, 11 CLEAR LAKE DR, CENTRALIA, 62801 President

Secretary

Name and Address Role
RAJENDRA R SHROFF Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 1000 500000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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