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  5. LIFE SERVICES, INC.

LIFE SERVICES, INC.

Company Details

Entity Name: LIFE SERVICES, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 13 Feb 1996
Date of Dissolution: 10 Jul 2015
Company Number: CORP_58715565
File Number: 58715565
Type of Business: All Inclusive Purpose
Date Status Change: 10 Jul 2015
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LIFE SERVICES, INC. 401(K) PROFIT SHARING PLAN 2015 371357646 2016-10-04 LIFE SERVICES, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-05-01
Business code 621399
Sponsor’s telephone number 3093978744
Plan sponsor’s address 2002 WEST DELRAY LANE, PEORIA, IL, 61614

Signature of
Role Plan administrator
Date 2016-10-04
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
LIFE SERVICES, INC. 401(K) PROFIT SHARING PLAN 2014 371357646 2015-04-06 LIFE SERVICES, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-05-01
Business code 621399
Sponsor’s telephone number 3093978744
Plan sponsor’s address 2002 WEST DELRAY LANE, PEORIA, IL, 61614

Signature of
Role Plan administrator
Date 2015-04-06
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-06
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
LIFE SERVICES, INC. 401(K) PROFIT SHARING PLAN 2013 371357646 2014-09-10 LIFE SERVICES, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-05-01
Business code 621399
Sponsor’s telephone number 3093978744
Plan sponsor’s address 2002 WEST DELRAY LANE, PEORIA, IL, 61614

Signature of
Role Plan administrator
Date 2014-09-10
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-09-10
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
LIFE SERVICES, INC. 401(K) PROFIT SHARING PLAN 2012 371357646 2013-09-27 LIFE SERVICES, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-05-01
Business code 621399
Sponsor’s telephone number 3093978744
Plan sponsor’s address 2002 WEST DELRAY LANE, PEORIA, IL, 61614

Signature of
Role Plan administrator
Date 2013-09-27
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-27
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
LIFE SERVICES, INC. 401(K) PROFIT SHARING PLAN 2011 371357646 2012-07-17 LIFE SERVICES, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-05-01
Business code 621399
Sponsor’s telephone number 3093978744
Plan sponsor’s address 2401 W. ALTA ROAD #602, PEORIA, IL, 61615

Plan administrator’s name and address
Administrator’s EIN 371357646
Plan administrator’s name LIFE SERVICES, INC.
Plan administrator’s address 2401 W. ALTA ROAD #602, PEORIA, IL, 61615
Administrator’s telephone number 3093978744

Signature of
Role Plan administrator
Date 2012-07-17
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-17
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
LIFE SERVICES, INC. 401(K) PROFIT SHARING PLAN 2010 371357646 2011-05-29 LIFE SERVICES, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-05-01
Business code 621399
Sponsor’s telephone number 3093978744
Plan sponsor’s address 2401 W. ALTA ROAD #602, PEORIA, IL, 61615

Plan administrator’s name and address
Administrator’s EIN 371357646
Plan administrator’s name LIFE SERVICES, INC.
Plan administrator’s address 2401 W. ALTA ROAD #602, PEORIA, IL, 61615
Administrator’s telephone number 3093978744

Signature of
Role Plan administrator
Date 2011-05-29
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-29
Name of individual signing ANDREA MOLL
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
TROY N PUDIK, 416 MAIN STE 1400, PEORIA, 61602, PEORIA Agent 2011-04-13

President

Name and Address Role
ANDREA MOLL, 2002 W. DELRAY DR, PEORIA, IL 61614 President

Historical Names

Name Change Date
PEORIA EXTRACORPOREAL LIFE SERVICES, INC. 2002-03-07

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 25000 1000000 No data

Related by officers

TROY N PUDIK, 416 MAIN STE 1400, PEORIA, 61602, PEORIA

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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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