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  5. PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC.

PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC.

Company Details

Entity Name: PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 30 May 2007
Company Number: CORP_65607379
File Number: 65607379
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2022 412241378 2024-03-05 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 27
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-03-05
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2021 412241378 2022-09-23 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 34
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2022-09-23
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2021 412241378 2023-10-23 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 32
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-10-23
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2020 412241378 2021-10-06 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 31
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 525 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-10-06
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2020 412241378 2021-09-17 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 31
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 525 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-09-17
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2019 412241378 2020-08-29 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 26
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 525 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2020-08-29
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2018 412241378 2020-01-24 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 29
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 1320 EXECUTIVE COURT, PEKIN, IL, 61554

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2020-01-24
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2018 412241378 2020-01-27 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 29
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 1320 EXECUTIVE COURT, PEKIN, IL, 61554

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2020-01-27
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2017 412241378 2018-10-05 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 26
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 1320 EXECUTIVE COURT, PEKIN, IL, 61554

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2018-10-05
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
JOHN EVANS SUPPORTIVE LIVING 401(K) PLAN 2016 412241378 2017-10-10 PEKIN DEVELOPMENT CORPORATION OF ILLINOIS, INC. 29
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 1320 EXECUTIVE COURT, PEKIN, IL, 61554

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2017-10-10
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
TAMMY MILLER, 200 LABOR DR, JACKSONVILLE, 62650, MORGAN Agent 2024-06-03

President

Name and Address Role
DAVID FRYE 1 N. OLD STATE CAPITOL PLZ. SPRINGFIELD IL 62701 President

Secretary

Name and Address Role
KARLEE MACER 8832 MARIO CREEK DR. INDIANAPOLIS IN 46234 Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100 100000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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