| Entity Name: | GUPTA MEDICAL CLINIC, LTD. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 23 Aug 2000 |
| Date of Dissolution: | 27 Feb 2014 |
| Company Number: | CORP_61213953 |
| File Number: | 61213953 |
| Type of Business: | Incorporated under the Medical Corporation Act |
| Date Status Change: | 27 Feb 2014 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GUPTA MEDICAL CLINIC LTD | 2012 | 364380077 | 2013-10-02 | GUPTA MEDICAL CLINIC LTD | 1 | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Active participants | 0 |
Signature of
| Role | Plan administrator |
| Date | 2013-10-02 |
| Name of individual signing | SANJAY ASIJA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2001-07-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8154596240 |
| Plan sponsor’s mailing address | 3419 DEEP WOOD DR, CRYSTAL LAKE, IL, 60012 |
| Plan sponsor’s address | 3419 DEEP WOOD DR, CRYSTAL LAKE, IL, 60012 |
Plan administrator’s name and address
| Administrator’s EIN | 364380077 |
| Plan administrator’s name | GUPTA MEDICAL CLINIC LTD |
| Plan administrator’s address | 3419 DEEP WOOD DR, CRYSTAL LAKE, IL, 60012 |
| Administrator’s telephone number | 8154596240 |
Number of participants as of the end of the plan year
| Active participants | 1 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 1 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2012-07-27 |
| Name of individual signing | SANJAY ASIJA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2001-07-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8154598240 |
| Plan sponsor’s mailing address | 3419 DEEP WOOD DR, CRYSTAL LAKE, IL, 60012 |
| Plan sponsor’s address | 3419 DEEP WOOD DR, CRYSTAL LAKE, IL, 60012 |
Plan administrator’s name and address
| Administrator’s EIN | 364380077 |
| Plan administrator’s name | GUPTA MEDICAL CLINIC LTD |
| Plan administrator’s address | 3419 DEEP WOOD DR, CRYSTAL LAKE, IL, 60012 |
| Administrator’s telephone number | 8154598240 |
Number of participants as of the end of the plan year
| Active participants | 1 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 1 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-07 |
| Name of individual signing | SANJAY ASIJA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2001-07-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8154597240 |
| Plan sponsor’s mailing address | 284 B MEMORIAL CT, CRYSTAL LAKE, IL, 60014 |
| Plan sponsor’s address | 284 B MEMORIAL CT, CRYSTAL LAKE, IL, 60014 |
Plan administrator’s name and address
| Administrator’s EIN | 364380077 |
| Plan administrator’s name | GUPTA MEDICAL CLINIC LTD |
| Plan administrator’s address | 284 B MEMORIAL CT, CRYSTAL LAKE, IL, 60014 |
| Administrator’s telephone number | 8154597240 |
Number of participants as of the end of the plan year
| Active participants | 1 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 1 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-19 |
| Name of individual signing | SANJAY ASIJA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| SANJEEV GUPTA, 284-B MEMORIAL CT, CRYSTAL LAKE, 60014, MC HENRY | Agent | 2006-08-03 |
| Name and Address | Role |
|---|---|
| SANJEEV GUPTA 6315-B NORTHWEST HWY CRYSTAL LAKE IL 60014 | President |
| License Type | License Number | Status | License Code | License Description | Business Activity | Date Issued | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|---|---|
| MEDICAL CORP | 042617258 | No data | No data | REGISTERED MEDICAL CORPORATION | No data | 2000-12-18 | 2013-11-18 | 2015-01-01 |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| A | No data | Voting Rights | 1000 | 1000000 | 0.01 |
Date of last update: 20 Jan 2025
