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ADAM GREENE INSURANCE AGENCY INC.

Company Details

Entity Name: ADAM GREENE INSURANCE AGENCY INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 13 Nov 2009
Company Number: CORP_67011155
File Number: 67011155
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADAM GREENE INSURANCE AGENCY 401(K) PLAN 2023 271358216 2024-06-27 ADAM GREENE INSURANCE AGENCY INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE., CHICAGO, IL, 60647

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2024-06-27
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
ADAM GREENE INSURANCE AGENCY 401(K) PLAN 2022 271358216 2023-06-22 ADAM GREENE INSURANCE AGENCY INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE., CHICAGO, IL, 60647

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2023-06-22
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
ADAM GREENE INSURANCE AGENCY 401(K) PLAN 2021 271358216 2022-05-23 ADAM GREENE INSURANCE AGENCY INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE., CHICAGO, IL, 60647

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2022-05-23
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
ADAM GREENE INSURANCE AGENCY 401(K) PLAN 2020 271358216 2021-06-15 ADAM GREENE INSURANCE AGENCY INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE., CHICAGO, IL, 60647

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2021-06-15
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
ADAM GREENE INSURANCE AGENCY 401(K) PLAN 2019 271358216 2020-06-24 ADAM GREENE INSURANCE AGENCY INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE., CHICAGO, IL, 60647

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2020-06-24
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
ADAM GREENE INSURANCE AGENCY 401(K) PLAN 2018 271358216 2020-05-18 ADAM GREENE INSURANCE AGENCY INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE., CHICAGO, IL, 60647

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2020-05-18
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
ADAM GREENE INSURANCE AGENCY 401(K) PLAN 2018 271358216 2019-09-20 ADAM GREENE INSURANCE AGENCY INC. 6
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE., CHICAGO, IL, 60647

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2019-09-20
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
ADAM GREENE INSURANCE AGENCY INC 2017 271358216 2018-08-27 ADAM GREENE INSURANCE AGENCY INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE, CHICAGO, IL, 60647

Signature of

Role Plan administrator
Date 2018-08-27
Name of individual signing ADAM GREENE
Valid signature Filed with authorized/valid electronic signature
ADAM GREENE INSURANCE AGENCY INC 2016 271358216 2017-05-18 ADAM GREENE INSURANCE AGENCY INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE, CHICAGO, IL, 60647

Signature of

Role Plan administrator
Date 2017-05-18
Name of individual signing ADAM GREENE
Valid signature Filed with authorized/valid electronic signature
ADAM GREENE INSURANCE AGENCY INC 2015 271358216 2016-07-05 ADAM GREENE INSURANCE AGENCY INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 524210
Sponsor’s telephone number 7733951111
Plan sponsor’s address 3621 W. NORTH AVE, CHICAGO, IL, 60647

Signature of

Role Plan administrator
Date 2016-07-05
Name of individual signing ADAM GREENE
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ADAM JONATHAN GREENE, 3621 W NORTH AVE, CHICAGO, 60647, COOK-NOT IN CITY OF CHICAGO Agent 2013-04-02

President

Name and Address Role
ADAM GREENE 3621 WEST NORTH AVENUE CHICAGO, IL 60647 President

Secretary

Name and Address Role
NONE Secretary

Shares

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

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State