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LAKE OF DECATUR, INC.

Company Details

Entity Name: LAKE OF DECATUR, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 19 Aug 2004
Company Number: CORP_63692298
File Number: 63692298
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAKE OF DECATUR, INC 401(K) PLAN 2023 201516499 2024-09-02 LAKE OF DECATUR, INC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-10-01
Business code 446110
Sponsor’s telephone number 2174295165
Plan sponsor’s address 245 W 1ST DRIVE, SUITE B, DECATUR, IL, 62521

Signature of

Role Plan administrator
Date 2024-09-02
Name of individual signing SHIRLEY HORNER
Valid signature Filed with authorized/valid electronic signature
LAKE OF DECATUR, INC 401(K) PLAN 2022 201516499 2023-07-19 LAKE OF DECATUR, INC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-10-01
Business code 446110
Sponsor’s telephone number 2174295165
Plan sponsor’s address 245 W 1ST DRIVE, SUITE B, DECATUR, IL, 62521

Signature of

Role Plan administrator
Date 2023-07-19
Name of individual signing SHIRLEY HORNER
Valid signature Filed with authorized/valid electronic signature
LAKE OF DECATUR, INC 401(K) PLAN 2021 201516499 2022-07-13 LAKE OF DECATUR, INC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-10-01
Business code 446110
Sponsor’s telephone number 2174295165
Plan sponsor’s address 245 W 1ST DRIVE, SUITE B, DECATUR, IL, 62521

Signature of

Role Plan administrator
Date 2022-07-13
Name of individual signing SHIRLEY HORNER
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
DALE G COLEE, 125 S 44TH ST, DECATUR, 62521, MACON Agent 2021-09-27

Secretary

Name and Address Role
RITA L COLEE 125 S 44TH ST DECATUR, IL 62521 Secretary

President

Name and Address Role
DALE G COLEE 125 S 44TH ST DECATUR, IL 62521 President

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
PHARMACY 054020012 No data No data LICENSED PHARMACY No data 2016-06-29 2024-02-04 2026-03-31
PHARMACY 054018441 No data No data LICENSED PHARMACY No data 2013-12-12 2024-02-04 2026-03-31
PHARMACY 054015385 No data No data LICENSED PHARMACY No data 2004-10-01 2024-02-04 2026-03-31

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
COLEE'S COMMUNITY PHARMACY Assume Name 2016-04-27 No data No data No data
COLEE'S CORNER DRUGS Assume Name 2013-08-28 No data No data No data
DALE'S SOUTHLAKE PHARMACY Assume Name 2004-08-19 No data No data No data

Shares

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

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State