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SAMLAND HEALTH CARE, INC.

Company Details

Entity Name: SAMLAND HEALTH CARE, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 17 Apr 1995
Date of Dissolution: 12 Sep 2014
Company Number: CORP_58297496
File Number: 58297496
Type of Business: All Inclusive Purpose
Date Status Change: 12 Sep 2014
Address 4320 W MONTROSE AVE A, CHICAGO, IL, 60641
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE BENEFIT PLAN OF SAMLAND HEALTH CARE, INC. 2013 364020993 2014-06-09 SAMLAND HEALTH CARE, INC. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621610
Sponsor’s telephone number 7732832525
Plan sponsor’s address 4320 W MONTROSE AVE, CHICAGO, IL, 60641

Signature of

Role Plan administrator
Date 2014-06-09
Name of individual signing FLORA SAMPANG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-09
Name of individual signing FLORA SAMPANG
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF SAMLAND HEALTH CARE, INC. 2012 364020993 2013-06-05 SAMLAND HEALTH CARE, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621610
Sponsor’s telephone number 7732832525
Plan sponsor’s address 4320 W MONTROSE AVE, CHICAGO, IL, 60641

Plan administrator’s name and address

Administrator’s EIN 364020993
Plan administrator’s name SAMLAND HEALTH CARE, INC.
Administrator’s telephone number 7732832525

Signature of

Role Plan administrator
Date 2013-06-05
Name of individual signing FLORA SAMPANG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-05
Name of individual signing FLORA SAMPANG
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF SAMLAND HEALTH CARE, INC. 2011 364020993 2012-10-05 SAMLAND HEALTH CARE, INC. 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621610
Sponsor’s telephone number 7732832525
Plan sponsor’s address 4320 W MONTROSE AVE, CHICAGO, IL, 60641

Plan administrator’s name and address

Administrator’s EIN 364020993
Plan administrator’s name SAMLAND HEALTH CARE, INC.
Plan administrator’s address 4320 W MONTROSE AVE, CHICAGO, IL, 60641
Administrator’s telephone number 7732832525

Signature of

Role Plan administrator
Date 2012-10-05
Name of individual signing FLORA SAMPANG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-05
Name of individual signing FLORA SAMPANG
Valid signature Filed with authorized/valid electronic signature
SAMLAND HEALTH CARE, INC. EMPLOYEES SAVINGS TRUST 2010 364020993 2011-07-05 SAMLAND HEALTH CARE, INC. 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621610
Sponsor’s telephone number 7732832525
Plan sponsor’s address 4320 WEST MONTROSE AVENUE, CHICAGO, IL, 60641

Plan administrator’s name and address

Administrator’s EIN 364020993
Plan administrator’s name SAMLAND HEALTH CARE, INC.
Plan administrator’s address 4320 WEST MONTROSE AVENUE, CHICAGO, IL, 60641
Administrator’s telephone number 7732832525

Signature of

Role Plan administrator
Date 2011-07-05
Name of individual signing FLORA SAMPANG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-05
Name of individual signing FLORA SAMPANG
Valid signature Filed with authorized/valid electronic signature
SAMLAND HEALTH CARE, INC. EMPLOYEES SAVINGS TRUST 2009 364020993 2010-07-09 SAMLAND HEALTH CARE, INC. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621610
Sponsor’s telephone number 7732832525
Plan sponsor’s address 4320 WEST MONTROSE AVENUE, CHICAGO, IL, 60641

Plan administrator’s name and address

Administrator’s EIN 364020993
Plan administrator’s name SAMLAND HEALTH CARE, INC.
Plan administrator’s address 4320 WEST MONTROSE AVENUE, CHICAGO, IL, 60641
Administrator’s telephone number 7732832525

Signature of

Role Plan administrator
Date 2010-07-08
Name of individual signing FLORA L. SAMPANG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-08
Name of individual signing FLORA L. SAMPANG
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
FLORA L SAMPANG, 4320 W MONTROSE AVE, CHICAGO, 60641, COOK-NOT IN CITY OF CHICAGO Agent 2003-04-10

Secretary

Name and Address Role Account Number
ALFREDO S SAMPANG Secretary 16380

President

Name and Address Role Account Number
FLORA L SAMPANG President 16380
FLORA SAMPANG, 15241 WAVERLY AVE MIDLOTHIAN 60445 President No data

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
BUSINESS LICENSE 1446549 Issued 1010 Limited Business License No data 2013-08-13 2013-08-16 2015-08-15
BUSINESS LICENSE 1122020 Cancelled 1010 Limited Business License No data 2003-05-01 2003-02-16 2004-02-15

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100000 3300000 No data

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State