| Entity Name: | FIRST SURGICAL ASSISTANTS INC. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 16 Nov 2005 |
| Date of Dissolution: | 11 Apr 2014 |
| Company Number: | CORP_64548247 |
| File Number: | 64548247 |
| Type of Business: | All Inclusive Purpose |
| Date Status Change: | 11 Apr 2014 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FIRST SURGICAL ASSISTANTS INC 401(K) P/S PLAN | 2012 | 203864655 | 2013-08-09 | FIRST SURGICAL ASSISTANTS INC | 4 | |||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 203864655 |
| Plan administrator’s name | FIRST SURGICAL ASSISTANTS INC |
| Plan administrator’s address | 16 S. DUNTON, ARLINGTON HEIGHTS, IL, 60005 |
| Administrator’s telephone number | 8473928800 |
Signature of
| Role | Plan administrator |
| Date | 2013-08-09 |
| Name of individual signing | CONSTANCE CZARNECKI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2011-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 8473928800 |
| Plan sponsor’s address | 1037 N. HARRISON STREET, ALGONQUIN, IL, 60102 |
Signature of
| Role | Plan administrator |
| Date | 2013-09-26 |
| Name of individual signing | CONSTANCE CZARNECKI |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2011-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 8473928800 |
| Plan sponsor’s address | 16 S. DUNTON, ARLINGTON HEIGHTS, IL, 60005 |
Plan administrator’s name and address
| Administrator’s EIN | 203864655 |
| Plan administrator’s name | FIRST SURGICAL ASSISTANTS INC |
| Plan administrator’s address | 16 S. DUNTON, ARLINGTON HEIGHTS, IL, 60005 |
| Administrator’s telephone number | 8473928800 |
Signature of
| Role | Plan administrator |
| Date | 2012-03-28 |
| Name of individual signing | CONSTANCE CZARNECKI |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2011-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 8473928800 |
| Plan sponsor’s address | 16 S. DUNTON, ARLINGTON HEIGHTS, IL, 60005 |
Plan administrator’s name and address
| Administrator’s EIN | 203864655 |
| Plan administrator’s name | FIRST SURGICAL ASSISTANTS INC |
| Plan administrator’s address | 16 S. DUNTON, ARLINGTON HEIGHTS, IL, 60005 |
| Administrator’s telephone number | 8473928800 |
Signature of
| Role | Plan administrator |
| Date | 2012-04-19 |
| Name of individual signing | CONSTANCE CZARNECKI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| STEVEN C CARBON, 201 N CHURCH RD, BENSENVILLE, 60106, DU PAGE | Agent | 2012-06-26 |
| Name and Address | Role |
|---|---|
| CONSTANCE CZARNECKI 10 GEORGE ST UNIT E BENSENVILLE 60106 | President |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 1000 | 100000 | No data |
Date of last update: 16 Jan 2025
