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PRISM EYE CARE, INC.

Company Details

Entity Name: PRISM EYE CARE, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 04 Apr 2007
Company Number: CORP_65410036
File Number: 65410036
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PRISM EYE CARE, INC. 401(K) PLAN 2023 208780000 2024-08-10 PRISM EYE CARE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 3123427007
Plan sponsor’s address 4552 N. LAWNDALE AVE, CHICAGO, IL, 60625

Signature of

Role Plan administrator
Date 2024-08-10
Name of individual signing NICK RICE
Valid signature Filed with authorized/valid electronic signature
PRISM EYE CARE, INC. 401(K) PLAN 2022 208780000 2023-07-21 PRISM EYE CARE, INC. 5
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 7085529006
Plan sponsor’s address 3448 NORTH MONTICELLO AVENUE, CHICAGO, IL, 60618

Signature of

Role Plan administrator
Date 2023-07-20
Name of individual signing EIMAN GAFOUR
Valid signature Filed with authorized/valid electronic signature
PRISM EYE CARE, INC. 401(K) PLAN 2021 208780000 2022-09-20 PRISM EYE CARE, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 3123427007
Plan sponsor’s address 3448 NORTH MONTICELLO AVENUE, CHICAGO, IL, 60618
PRISM EYE CARE, INC. 401(K) PLAN 2020 208780000 2021-09-27 PRISM EYE CARE, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 3123427007
Plan sponsor’s address 3448 NORTH MONTICELLO AVENUE, CHICAGO, IL, 60618

Signature of

Role Plan administrator
Date 2021-09-27
Name of individual signing EIMAN GAFOUR
Valid signature Filed with authorized/valid electronic signature
PRISM EYE CARE, INC. 401(K) PLAN 2019 208780000 2020-07-23 PRISM EYE CARE, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 3123427007
Plan sponsor’s address 3448 NORTH MONTICELLO AVENUE, CHICAGO, IL, 60618

Signature of

Role Plan administrator
Date 2020-07-23
Name of individual signing EIMAN GAFOUR
Valid signature Filed with authorized/valid electronic signature
PRISM EYE CARE, INC. 401(K) PLAN 2018 208780000 2019-10-01 PRISM EYE CARE, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 3123427007
Plan sponsor’s address 3448 NORTH MONTICELLO AVENUE, CHICAGO, IL, 60618

Signature of

Role Plan administrator
Date 2019-10-01
Name of individual signing EIMAN GAFOUR
Valid signature Filed with authorized/valid electronic signature
PRISM EYE CARE, INC. 401(K) PLAN 2017 208780000 2018-10-02 PRISM EYE CARE, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 3123427007
Plan sponsor’s address 3448 NORTH MONTICELLO AVENUE, CHICAGO, IL, 60618

Signature of

Role Plan administrator
Date 2018-10-02
Name of individual signing EIMAN GAFOUR
Valid signature Filed with authorized/valid electronic signature
PRISM EYE CARE, INC. 401(K) PLAN 2016 208780000 2017-07-21 PRISM EYE CARE, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 3123427007
Plan sponsor’s address 3448 NORTH MONTICELLO AVENUE, CHICAGO, IL, 60618

Signature of

Role Plan administrator
Date 2017-07-21
Name of individual signing EIMAN GAFOUR
Valid signature Filed with authorized/valid electronic signature
PRISM EYE CARE, INC. 401(K) PLAN 2015 208780000 2016-07-21 PRISM EYE CARE, INC. 2
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 3123427007
Plan sponsor’s address 3448 NORTH MONTICELLO AVENUE, CHICAGO, IL, 60618

Signature of

Role Plan administrator
Date 2016-07-20
Name of individual signing EIMAN GAFOUR
Valid signature Filed with authorized/valid electronic signature
PRISM EYE CARE, INC. 401(K) PLAN 2013 208780000 2014-07-29 PRISM EYE CARE, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621320
Sponsor’s telephone number 7085529006
Plan sponsor’s address 3448 NORTH MONTICELLO AVENUE, CHICAGO, IL, 60618

Signature of

Role Plan administrator
Date 2014-07-29
Name of individual signing EIMAN GAFOUR
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
KAIZEN CPAS + ADVISORS, 16 EXECUTIVE CT STE 2, SOUTH BARRINGTON, 60010, COOK-NOT IN CITY OF CHICAGO Agent 2022-05-03

President

Name and Address Role
GAFOUR EIMAN, 3448 NORTH MONTICELLO AVENUE, CHICAGO IL 60618 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100000 100000 No data

Date of last update: 20 Jan 2025

Sources: Illinois Office of the Secretary of State