| Entity Name: | WARREN MUSIC BOOSTER CLUB |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Not-for-Profit |
| Status: | Dissolved |
| Date Formed: | 04 May 2000 |
| Date of Dissolution: | 08 Oct 2010 |
| Company Number: | CORP_61071997 |
| File Number: | 61071997 |
| Type of Business: | Not for Profit |
| Date Status Change: | 08 Oct 2010 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EMPLOYEE BENEFIT PLAN OF SAMLAND HEALTH CARE, INC. | 2011 | 364020993 | 2012-10-05 | SAMLAND HEALTH CARE, INC. | 55 | |||||||||||||||||||||||||||||||||||||||||
|
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| 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 |
| 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 |
| 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 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| RACHEL LYNN BRINKMEIER, 118 E MAIN ST, WARREN, 61087, JO DAVIESS | Agent | 2000-05-04 |
Date of last update: 13 Jan 2025
