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GOELLNER, INC.

Company Details

Entity Name: GOELLNER, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 20 Dec 1999
Company Number: CORP_60816387
File Number: 60816387
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GOELLNER INC EMPLOYER GROUP HEALTH PLAN 2023 364348436 2024-07-25 GOELLNER, INC. 417
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1997-01-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 432
GOELLNER INC EMPLOYER GROUP HEALTH PLAN 2022 364348436 2023-07-31 GOELLNER, INC. 338
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1997-01-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 366
GOELLNER INC EMPLOYER GROUP HEALTH PLAN 2021 364348436 2022-07-25 GOELLNER, INC. 306
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1997-01-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 306
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
GOELLNER INC EMPLOYER GROUP HEALTH PLAN 2020 364348436 2021-10-01 GOELLNER, INC. 379
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1997-01-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 379
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
GOELLNER, INC. EYEMED VISION CARE 2018 364348436 2019-10-18 GOELLNER, INC. 397
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2013-01-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 409

Signature of

Role Plan administrator
Date 2019-10-18
Name of individual signing ALEX GOELLNER
Valid signature Filed with authorized/valid electronic signature
GOELLNER INC EMPLOYER GROUP HEALTH PLAN 2018 364348436 2019-10-18 GOELLNER, INC. 271
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1997-01-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 286

Signature of

Role Plan administrator
Date 2019-10-18
Name of individual signing ALEX GOELLNER
Valid signature Filed with authorized/valid electronic signature
GOELLNER, INC. EYEMED VISION CARE 2017 364348436 2018-10-15 GOELLNER, INC. 375
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2013-01-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 397

Signature of

Role Plan administrator
Date 2018-10-15
Name of individual signing ALEX GOELLNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-12
Name of individual signing MELISSA SWARD
Valid signature Filed with authorized/valid electronic signature
GOELLNER, INC. LIFE, LTD, STD, AND INDEMNITY PLANS 2017 364348436 2018-10-15 GOELLNER, INC. 300
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2002-12-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 263

Signature of

Role Plan administrator
Date 2018-10-15
Name of individual signing ALEX GOELLNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-12
Name of individual signing MELISSA SWARD
Valid signature Filed with authorized/valid electronic signature
GOELLNER, INC. EMPLOYER GROUP HEALTH PLAN 2017 364348436 2018-10-15 GOELLNER, INC. 247
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1997-01-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 271

Signature of

Role Plan administrator
Date 2018-10-15
Name of individual signing ALEX GOELLNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-12
Name of individual signing MELISSA SWARD
Valid signature Filed with authorized/valid electronic signature
GOELLNER, INC. LIFE, LTD, STD, AND INDEMNITY PLANS 2016 364348436 2017-09-13 GOELLNER, INC 278
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2002-12-01
Business code 332900
Sponsor’s telephone number 8159626076
Plan sponsor’s mailing address 2500 LATHAM ST, ROCKFORD, IL, 611033963
Plan sponsor’s address 2500 LATHAM ST, ROCKFORD, IL, 611033963

Number of participants as of the end of the plan year

Active participants 300

Signature of

Role Plan administrator
Date 2017-08-30
Name of individual signing ALEX GOELLNER
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JAMES M. ALLEN, 839 N PERRYVILLE RD STE. 200, ROCKFORD, 61107, WINNEBAGO Agent 2022-08-12

President

Name and Address Role
DIETMAR GOELLNER, 7761 MONTICELLO DR ROCKFORD IL 61103 President

Secretary

Name and Address Role
MARIKA MERTZ, 1035 LUANNA DR ROCKFORD IL 61103 Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
A COMM VOTING No data Voting Rights 500000 1709000 No data
B COMM VOTING No data Voting Rights 500000 1139000 No data
C COMM NON-VOTING No data No Voting Rights 500000 31278000 No data

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State