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  5. FERNANDEZ INSURANCE AGENCY, INC.

FERNANDEZ INSURANCE AGENCY, INC.

Company Details

Entity Name: FERNANDEZ INSURANCE AGENCY, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 06 Dec 2006
Company Number: CORP_65283999
File Number: 65283999
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FERNANDEZ INSURANCE AGENCY 401K PLAN 2023 208011941 2024-07-15 FERNANDEZ INSURANCE AGENCY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 524150
Sponsor’s telephone number 7702522100
Plan sponsor’s address 1719 N. WESTERN AVENUE, SUITE C-1, CHICAGO, IL, 60647

Signature of
Role Plan administrator
Date 2024-07-15
Name of individual signing PETER FERNANDEZ
Valid signature Filed with authorized/valid electronic signature
FERNANDEZ INSURANCE AGENCY 401K PLAN 2022 208011941 2023-07-18 FERNANDEZ INSURANCE AGENCY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 524150
Sponsor’s telephone number 7702522100
Plan sponsor’s address 1719 N. WESTERN AVENUE, SUITE C-1, CHICAGO, IL, 60647

Signature of
Role Plan administrator
Date 2023-07-18
Name of individual signing PETER FERNANDEZ
Valid signature Filed with authorized/valid electronic signature
FERNANDEZ INSURANCE AGENCY 401K PLAN 2021 208011941 2022-05-18 FERNANDEZ INSURANCE AGENCY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 524150
Sponsor’s telephone number 7702522100
Plan sponsor’s address 1719 N. WESTERN AVENUE, SUITE C-1, CHICAGO, IL, 60647

Signature of
Role Plan administrator
Date 2022-05-18
Name of individual signing PETER FERNANDEZ
Valid signature Filed with authorized/valid electronic signature
FERNANDEZ INSURANCE AGENCY 401K PLAN 2020 208011941 2021-04-26 FERNANDEZ INSURANCE AGENCY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 524150
Sponsor’s telephone number 7702522100
Plan sponsor’s address 1719 N. WESTERN AVENUE, SUITE C-1, CHICAGO, IL, 60647

Signature of
Role Plan administrator
Date 2021-04-26
Name of individual signing PETER FERNANDEZ
Valid signature Filed with authorized/valid electronic signature
FERNANDEZ INSURANCE AGENCY 401K PLAN 2019 208011941 2020-05-22 FERNANDEZ INSURANCE AGENCY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 524150
Sponsor’s telephone number 7702522100
Plan sponsor’s address 1719 N. WESTERN AVENUE, SUITE C-1, CHICAGO, IL, 60647

Signature of
Role Plan administrator
Date 2020-05-22
Name of individual signing PETER FERNANDEZ
Valid signature Filed with authorized/valid electronic signature
FERNANDEZ INSURANCE AGENCY 401K PLAN 2018 208011941 2019-04-16 FERNANDEZ INSURANCE AGENCY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 524150
Sponsor’s telephone number 7702522100
Plan sponsor’s address 1719 N. WESTERN AVENUE, SUITE C-1, CHICAGO, IL, 60647

Signature of
Role Plan administrator
Date 2019-04-16
Name of individual signing PETER FERNANDEZ
Valid signature Filed with authorized/valid electronic signature
FERNANDEZ INSURANCE AGENCY 401K PLAN 2017 208011941 2018-04-25 FERNANDEZ INSURANCE AGENCY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 524150
Sponsor’s telephone number 7702522100
Plan sponsor’s address 1719 N. WESTERN AVENUE, SUITE C-1, CHICAGO, IL, 60647

Signature of
Role Plan administrator
Date 2018-04-25
Name of individual signing PETER FERNANDEZ
Valid signature Filed with authorized/valid electronic signature
FERNANDEZ INSURANCE AGENCY 401K PLAN 2016 208011941 2017-04-24 FERNANDEZ INSURANCE AGENCY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 524150
Sponsor’s telephone number 7702522100
Plan sponsor’s address 1719 N. WESTERN AVENUE, SUITE C-1, CHICAGO, IL, 60647

Signature of
Role Plan administrator
Date 2017-04-24
Name of individual signing PETER FERNANDEZ
Valid signature Filed with authorized/valid electronic signature
FERNANDEZ INSURANCE AGENCY 401K PLAN 2015 208011941 2016-07-21 FERNANDEZ INSURANCE AGENCY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 524150
Sponsor’s telephone number 7702522100
Plan sponsor’s address 1719 N. WESTERN AVENUE, SUITE C-1, CHICAGO, IL, 60647

Agent

Name and Address Role Appointment Date
PETER BENIGNO FERNANDEZ, 1032 S ALDINE AVE, PARK RIDGE, 60068, COOK-NOT IN CITY OF CHICAGO Agent 2017-09-27

President

Name and Address Role
PETER B FERNANDEZ, 1719 N WESTERN AVE #C-1 CHICAGO IL 60647 President

Secretary

Name and Address Role
PETER B FERNANDEZ Secretary

Shares

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

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State

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