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  5. HARVEY PALLETS, INC.

HARVEY PALLETS, INC.

Company Details

Entity Name: HARVEY PALLETS, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 06 Apr 2000
Company Number: CORP_61018476
File Number: 61018476
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HARVEY PALLETS INC. 401(K) PLAN 2023 364360809 2024-10-10 HARVEY PALLETS INC. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-07-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 W. WESTERN AVENUE, BLUE ISLAND, IL, 60406

Signature of
Role Plan administrator
Date 2024-10-10
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-10
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
HARVEY PALLETS, INC. 401(K) PLAN 2022 364360809 2023-06-01 HARVEY PALLETS, INC. 79
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-07-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 S. WESTERN AVE., BLUE ISLAND, IL, 60406

Signature of
Role Plan administrator
Date 2023-05-31
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-31
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
HARVEY PALLETS INC MEDOVA LIFESTYLE HEALTH PLAN 2021 364360809 2024-07-12 HARVEY PALLETS INC 0
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-12-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 WESTERN AVE, BLUE ISLAND, IL, 604065057

Plan administrator’s name and address
Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT INC
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of
Role Plan administrator
Date 2024-07-12
Name of individual signing ROBERT MOORE
Valid signature Filed with authorized/valid electronic signature
HARVEY PALLETS, INC. 401(K) PLAN 2021 364360809 2022-02-10 HARVEY PALLETS, INC. 71
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-07-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 S. WESTERN AVE., BLUE ISLAND, IL, 60406

Signature of
Role Plan administrator
Date 2022-02-10
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-02-10
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
HARVEY PALLETS, INC. 401(K) PLAN 2020 364360809 2021-05-11 HARVEY PALLETS, INC. 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-07-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 S. WESTERN AVE., BLUE ISLAND, IL, 60406

Signature of
Role Plan administrator
Date 2021-05-11
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-11
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
HARVEY PALLETS INC MEDOVA LIFESTYLE HEALTH PLAN 2020 364360809 2022-09-02 HARVEY PALLETS INC 26
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-12-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 WESTERN AVE, BLUE ISLAND, IL, 604065057

Plan administrator’s name and address
Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT INC
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of
Role Plan administrator
Date 2022-08-31
Name of individual signing ROBERT MOORE
Valid signature Filed with authorized/valid electronic signature
HARVEY PALLETS, INC. 401(K) PLAN 2019 364360809 2020-06-11 HARVEY PALLETS, INC. 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-07-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 S. WESTERN AVE., BLUE ISLAND, IL, 60406

Signature of
Role Plan administrator
Date 2020-06-11
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-11
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
HARVEY PALLETS, INC. 401(K) PLAN 2018 364360809 2019-05-29 HARVEY PALLETS, INC. 70
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-07-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 S. WESTERN AVE., BLUE ISLAND, IL, 60406

Signature of
Role Plan administrator
Date 2019-05-24
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-24
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
HARVEY PALLETS, INC. 401(K) PLAN 2017 364360809 2018-09-21 HARVEY PALLETS, INC. 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-07-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 S. WESTERN AVE., BLUE ISLAND, IL, 60406

Signature of
Role Plan administrator
Date 2018-09-21
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-21
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
HARVEY PALLETS, INC. 401(K) PLAN 2016 364360809 2017-08-08 HARVEY PALLETS, INC. 70
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-07-01
Business code 321900
Sponsor’s telephone number 7082931831
Plan sponsor’s address 13601 S. WESTERN AVE., BLUE ISLAND, IL, 60406

Signature of
Role Plan administrator
Date 2017-08-08
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-08
Name of individual signing JOHANA LOPEZ
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JOHN Z TOSCAS, 12616 S HARLEM AVE, PALOS HEIGHTS, 60463, COOK-NOT IN CITY OF CHICAGO Agent 2012-06-18

President

Name and Address Role
JOSE M. TAVAREZ, 13601 WESTERNAVE., BLUE ISLAND, IL 60406 President

Secretary

Name and Address Role
JULIA TAVAREZ, 13601 WESTERN AVE., BLUE ISLAND, IL 60406 Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 1000000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State

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