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  5. JAMES K. POTTS D.D.S. P.C.

JAMES K. POTTS D.D.S. P.C.

Company Details

Entity Name: JAMES K. POTTS D.D.S. P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 20 Sep 2004
Date of Dissolution: 09 Oct 2024
Company Number: CORP_63776998
File Number: 63776998
Type of Business: Incorporated under the Professional Service Corporation Act
Date Status Change: 09 Oct 2024
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JAMES K POTTS MONEY PURCHASE PENSION PLAN AND TRUST 2019 201916454 2020-07-19 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736256442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8214 W ADDISON ST, CHICAGO, IL, 606341950

Signature of
Role Plan administrator
Date 2020-07-19
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-19
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
JAMES K POTTS MONEY PURCHASE PENSION PLAN AND TRUST 2018 201916454 2019-07-15 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736256442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8214 W ADDISON ST, CHICAGO, IL, 606341950

Signature of
Role Plan administrator
Date 2019-07-15
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-15
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
JAMES K POTTS MONEY PURCHASE PENSION PLAN AND TRUST 2017 201916454 2018-07-12 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736256442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8214 W ADDISON ST, CHICAGO, IL, 606341950

Signature of
Role Plan administrator
Date 2018-07-12
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-12
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
JAMES K POTTS MONEY PURCHASE PENSION PLAN AND TRUST 2016 201916454 2017-06-28 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736256442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8214 W ADDISON ST, CHICAGO, IL, 606341950

Signature of
Role Plan administrator
Date 2017-06-28
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-28
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
JAMES K POTTS MONEY PURCHASE PENSION PLAN AND TRUST 2015 201916454 2016-10-14 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736256442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8214 W ADDISON ST, CHICAGO, IL, 606341950

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
JAMES K POTTS MONEY PURCHASE PENSION PLAN AND TRUST 2014 201916454 2015-07-29 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736256442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8214 W ADDISON, CHICAGO, IL, 60634

Signature of
Role Plan administrator
Date 2015-07-29
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-29
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
JAMES K POTTS MONEY PURCHASE PENSION PLAN AND TRUST 2013 201916454 2014-07-23 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736256442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8214 W ADDISON, CHICAGO, IL, 60634

Signature of
Role Plan administrator
Date 2014-07-23
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
JAMES K POTTS MONEY PURCHACE PENSION PLAN AND TRUST 2012 201916454 2013-07-17 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736256442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8214 W ADDISON ST., CHICAGO, IL, 60634

Signature of
Role Plan administrator
Date 2013-07-17
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
JAMES K POTTS MONEY PURCHASE PENSION PLAN AND TRUST 2011 201916454 2012-07-22 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736256442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8214 W ADDISON ST., CHICAGO, IL, 60634

Plan administrator’s name and address
Administrator’s EIN 201916454
Plan administrator’s name JAMES K POTTS
Plan administrator’s address 8214 W ADDISON ST., CHICAGO, IL, 60634
Administrator’s telephone number 7736256442

Signature of
Role Plan administrator
Date 2012-07-22
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature
JAMES K POTTS MONEY PURCHASE PENSION PLAN AND TRUST 2010 201916454 2011-07-27 JAMES K POTTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621210
Sponsor’s telephone number 7736259442
Plan sponsor’s DBA name JAMES K POTTS DDS PC
Plan sponsor’s address 8124 W ADDISON ST., CHICAGO, IL, 60634

Plan administrator’s name and address
Administrator’s EIN 201916454
Plan administrator’s name JAMES K POTTS
Plan administrator’s address 8124 W ADDISON ST., CHICAGO, IL, 60634
Administrator’s telephone number 7736259442

Signature of
Role Plan administrator
Date 2011-07-27
Name of individual signing JAMES POTTS
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JAMES K POTTS, 8214 W ADDISON, CHICAGO, 60634, COOK-NOT IN CITY OF CHICAGO Agent 2004-09-20

President

Name and Address Role
JAMES K POTTS, 1335 SHAGBACK DR DES PLAINES 60018 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 600000 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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