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PREMIER INSURANCE NETWORK, INC.

Company Details

Entity Name: PREMIER INSURANCE NETWORK, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 02 Feb 2012
Date of Dissolution: 11 Jul 2014
Company Number: CORP_68267099
File Number: 68267099
Type of Business: All Inclusive Purpose
Date Status Change: 11 Jul 2014
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIER INSURANCE NETWORK, INC. 401(K) PLAN 2012 454483960 2014-02-25 PREMIER INSURANCE NETWORK, INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-02-03
Business code 524210
Sponsor’s telephone number 3128048587
Plan sponsor’s mailing address 381 E. DEERPATH ROAD, LAKE FOREST, IL, 60045
Plan sponsor’s address 381 E. DEERPATH ROAD, LAKE FOREST, IL, 60045

Number of participants as of the end of the plan year

Active participants 1
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2014-02-25
Name of individual signing NANCY FUNK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-02-25
Name of individual signing NANCY FUNK
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2014-02-25
Name of individual signing NANCY FUNK
Valid signature Filed with authorized/valid electronic signature
PREMIER INSURANCE NETWORK, INC. 401(K) PLAN 2012 454483960 2013-10-15 PREMIER INSURANCE NETWORK, INC. 0
Three-digit plan number (PN) 001
Effective date of plan 2012-02-03
Business code 524210
Sponsor’s telephone number 3128048587
Plan sponsor’s mailing address 381 E. DEERPATH ROAD, LAKE FOREST, IL, 60045
Plan sponsor’s address 381 E. DEERPATH ROAD, LAKE FOREST, IL, 60045

Number of participants as of the end of the plan year

Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2013-10-15
Name of individual signing NANCY FUNK
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
KEVIN CALLAHAN, 1100 HAVENWOOD LN, LAKE FOREST, 60045, LAKE Agent 2012-02-02

President

Name and Address Role
KEVIN CALLAHAN, 856 OAK STREET, WINNETKA, 60093 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 120000 704000 10

Date of last update: 13 Feb 2025

Sources: Illinois Office of the Secretary of State