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KOLLER INSURANCE SERVICES, INC.

Company Details

Entity Name: KOLLER INSURANCE SERVICES, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 13 Apr 2000
Company Number: CORP_61012435
File Number: 61012435
Type of Business: Insurance and/or real estate agencies and brokers
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KOLLER INSURANCE SERVICES, INC. 401K PS PLAN 2023 364358655 2024-07-16 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Signature of

Role Plan administrator
Date 2024-07-16
Name of individual signing THOMAS C KOLLER
Valid signature Filed with authorized/valid electronic signature
KOLLER INSURANCE SERVICES, INC. 401(K) P/S PLAN 2022 364358655 2023-05-22 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Plan administrator’s name and address

Administrator’s EIN 364358655
Plan administrator’s name KOLLER INSURANCE SERVICES INC.
Plan administrator’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516
Administrator’s telephone number 6308294999

Signature of

Role Plan administrator
Date 2023-05-22
Name of individual signing THOMAS KOLLER
Valid signature Filed with authorized/valid electronic signature
KOLLER INSURANCE SERVICES, INC. 401(K) P/S PLAN 2021 364358655 2022-06-10 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Plan administrator’s name and address

Administrator’s EIN 364358655
Plan administrator’s name KOLLER INSURANCE SERVICES INC.
Plan administrator’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516
Administrator’s telephone number 6308294999

Signature of

Role Plan administrator
Date 2022-06-10
Name of individual signing THOMAS KOLLER
Valid signature Filed with authorized/valid electronic signature
KOLLER INSURANCE SERVICES, INC. 401(K) P/S PLAN 2020 364358655 2021-05-13 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Plan administrator’s name and address

Administrator’s EIN 364358655
Plan administrator’s name KOLLER INSURANCE SERVICES INC.
Plan administrator’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516
Administrator’s telephone number 6308294999

Signature of

Role Plan administrator
Date 2021-05-13
Name of individual signing THOMAS KOLLER
Valid signature Filed with authorized/valid electronic signature
KOLLER INSURANCE SERVICES, INC. 401(K) P/S PLAN 2019 364358655 2020-04-24 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Plan administrator’s name and address

Administrator’s EIN 364358655
Plan administrator’s name KOLLER INSURANCE SERVICES INC.
Plan administrator’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516
Administrator’s telephone number 6308294999

Signature of

Role Plan administrator
Date 2020-04-24
Name of individual signing THOMAS KOLLER
Valid signature Filed with authorized/valid electronic signature
KOLLER INSURANCE SERVICES, INC. 401(K) P/S PLAN 2018 364358655 2019-05-09 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Plan administrator’s name and address

Administrator’s EIN 364358655
Plan administrator’s name KOLLER INSURANCE SERVICES INC.
Plan administrator’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516
Administrator’s telephone number 6308294999

Signature of

Role Plan administrator
Date 2019-05-09
Name of individual signing THOMAS KOLLER
Valid signature Filed with authorized/valid electronic signature
KOLLER INSURANCE SERVICES, INC. 401(K) P/S PLAN 2017 364358655 2018-03-26 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Plan administrator’s name and address

Administrator’s EIN 364358655
Plan administrator’s name KOLLER INSURANCE SERVICES INC.
Plan administrator’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516
Administrator’s telephone number 6308294999

Signature of

Role Plan administrator
Date 2018-03-26
Name of individual signing THOMAS KOLLER
Valid signature Filed with authorized/valid electronic signature
KOLLER INSURANCE SERVICES, INC. 401(K) P/S PLAN 2016 364358655 2017-03-31 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Plan administrator’s name and address

Administrator’s EIN 364358655
Plan administrator’s name KOLLER INSURANCE SERVICES INC.
Plan administrator’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516
Administrator’s telephone number 6308294999

Signature of

Role Plan administrator
Date 2017-03-31
Name of individual signing THOMAS KOLLER
Valid signature Filed with authorized/valid electronic signature
KOLLER INSURANCE SERVICES, INC. 401(K) P/S PLAN 2015 364358655 2016-07-12 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Plan administrator’s name and address

Administrator’s EIN 364358655
Plan administrator’s name KOLLER INSURANCE SERVICES INC.
Plan administrator’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516
Administrator’s telephone number 6308294999

Signature of

Role Plan administrator
Date 2016-07-12
Name of individual signing THOMAS KOLLER
Valid signature Filed with authorized/valid electronic signature
KOLLER INSURANCE SERVICES, INC. 401(K) P/S PLAN 2014 364358655 2015-05-27 KOLLER INSURANCE SERVICES INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 524210
Sponsor’s telephone number 6308294999
Plan sponsor’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516

Plan administrator’s name and address

Administrator’s EIN 364358655
Plan administrator’s name KOLLER INSURANCE SERVICES INC.
Plan administrator’s address 6400 WOODWARD AVE, DOWNERS GROVE, IL, 60516
Administrator’s telephone number 6308294999

Signature of

Role Plan administrator
Date 2015-05-27
Name of individual signing THOMAS KOLLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
THOMAS C KOLLER, 6400 WOODWARD AVE, DOWNERS GROVE, 60516, DU PAGE Agent 2000-04-13

President

Name and Address Role
THOMAS C KOLLER, 307 ABERDOURLANE NAPERVILLE 60540 President

Secretary

Name and Address Role
LINDA KOLLER Secretary

Shares

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

Date of last update: 13 Feb 2025

Sources: Illinois Office of the Secretary of State