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BANSAN FOUNDATION

Company Details

Entity Name: BANSAN FOUNDATION
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 28 Nov 2006
Company Number: CORP_65222337
File Number: 65222337
Type of Business: Not for Profit
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BANSAN FOUNDATION 403(B) PLAN 2023 205970885 2024-07-02 BANSAN FOUNDATION 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 611000
Sponsor’s telephone number 7087984600
Plan sponsor’s address 740 WESTERN AVE, FLOSSMOOR, IL, 60422

Signature of

Role Plan administrator
Date 2024-07-02
Name of individual signing SANJIV S MODI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-02
Name of individual signing SANJIV S MODI
Valid signature Filed with authorized/valid electronic signature
BANSAN FOUNDATION 403(B) PLAN 2023 205970885 2024-06-18 BANSAN FOUNDATION 13
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 611000
Sponsor’s telephone number 7087984600
Plan sponsor’s address 740 WESTERN AVE, FLOSSMOOR, IL, 60422

Signature of

Role Plan administrator
Date 2024-06-18
Name of individual signing SANIJV S MODI
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2024-06-18
Name of individual signing BANSARI S MODI
Valid signature Filed with authorized/valid electronic signature
BANSAN FOUNDATION 403(B) PLAN 2022 205970885 2023-04-03 BANSAN FOUNDATION 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 611000
Sponsor’s telephone number 7087984600
Plan sponsor’s address 740 WESTERN AVENUE, FLOSSMOOR, IL, 60422

Signature of

Role Plan administrator
Date 2023-04-03
Name of individual signing SANJIV S MODI
Valid signature Filed with authorized/valid electronic signature
BANSAN FOUNDATION 403(B) PLAN 2021 205970885 2022-07-06 BANSAN FOUNDATION 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 611000
Sponsor’s telephone number 7087984600
Plan sponsor’s address 740 WESTERN AVENUE, FLOSSMOOR, IL, 60422

Signature of

Role Plan administrator
Date 2022-07-06
Name of individual signing BANSARI MODI
Valid signature Filed with authorized/valid electronic signature
BANSAN FOUNDATION 403(B) PLAN 2020 205970885 2021-05-18 BANSAN FOUNDATION 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 611000
Sponsor’s telephone number 7087984600
Plan sponsor’s address 740 WESTERN AVE, FLOSSMOOR, IL, 60422

Signature of

Role Plan administrator
Date 2021-05-18
Name of individual signing SANJIV S MODI
Valid signature Filed with authorized/valid electronic signature
BANSAN FOUNDATION 403(B) PLAN 2019 205970885 2020-03-18 BANSAN FOUNDATION 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 611000
Sponsor’s telephone number 7087984600
Plan sponsor’s address 740 WESTERN AVE, FLOSSMOOR, IL, 60422

Signature of

Role Plan administrator
Date 2020-03-18
Name of individual signing SANJIV S MODI
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
BANSARI S MODI, 740 WESTERN AVE, FLOSSMOOR, 60422, COOK-NOT IN CITY OF CHICAGO Agent 2014-01-16

Date of last update: 13 Feb 2025

Sources: Illinois Office of the Secretary of State