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  5. CORLEY FAMILY DENTAL P.C.

CORLEY FAMILY DENTAL P.C.

Company Details

Entity Name: CORLEY FAMILY DENTAL P.C.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 24 Sep 2012
Company Number: CORP_68586275
File Number: 68586275
Type of Business: Incorporated under the Professional Service Corporation Act
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CORLEY FAMILY DENTAL, P. C. 401(K) PROFIT-SHARING PLAN & TRUST 2023 383889130 2024-07-17 CORLEY FAMILY DENTAL, P.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2173306217
Plan sponsor’s address 160 WEST MCKINLEY AVENUE, DECATUR, IL, 62526

Signature of
Role Plan administrator
Date 2024-07-17
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-17
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
CORLEY FAMILY DENTAL, P. C. 401(K) PROFIT-SHARING PLAN & TRUST 2022 383889130 2023-06-11 CORLEY FAMILY DENTAL, P.C. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2173306217
Plan sponsor’s address 160 WEST MCKINLEY AVENUE, DECATUR, IL, 62526

Signature of
Role Plan administrator
Date 2023-06-11
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-06-11
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
CORLEY FAMILY DENTAL, P. C. 401(K) PROFIT-SHARING PLAN & TRUST 2021 383889130 2022-07-14 CORLEY FAMILY DENTAL, P.C. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2173306217
Plan sponsor’s address 160 WEST MCKINLEY AVENUE, DECATUR, IL, 62526

Signature of
Role Plan administrator
Date 2022-07-14
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-14
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
CORLEY FAMILY DENTAL, P. C. 401(K) PROFIT-SHARING PLAN & TRUST 2020 383889130 2021-06-21 CORLEY FAMILY DENTAL, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2173306217
Plan sponsor’s address 160 WEST MCKINLEY AVENUE, DECATUR, IL, 62526

Signature of
Role Plan administrator
Date 2021-06-21
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-06-21
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
CORLEY FAMILY DENTAL, P. C. 401(K) PROFIT-SHARING PLAN & TRUST 2019 383889130 2020-05-03 CORLEY FAMILY DENTAL, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2173306217
Plan sponsor’s address 160 WEST MCKINLEY AVENUE, DECATUR, IL, 62526

Signature of
Role Plan administrator
Date 2020-05-03
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-05-03
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
CORLEY FAMILY DENTAL, P. C. 401(K) PROFIT-SHARING PLAN & TRUST 2018 383889130 2019-07-08 CORLEY FAMILY DENTAL, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2173306217
Plan sponsor’s address 160 WEST MCKINLEY AVENUE, DECATUR, IL, 62526

Signature of
Role Plan administrator
Date 2019-07-08
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-08
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
CORLEY FAMILY DENTAL, P. C. 401(K) PROFIT-SHARING PLAN & TRUST 2017 383889130 2018-07-06 CORLEY FAMILY DENTAL, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2173306217
Plan sponsor’s address 160 WEST MCKINLEY AVENUE, DECATUR, IL, 62526

Signature of
Role Plan administrator
Date 2018-07-06
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-06
Name of individual signing NATALIE A. CORLEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
NATALIE ANN CORLEY, 160 W MCKINLEY ST, DECATUR, 62526, MACON Agent 2016-11-28

President

Name and Address Role
NATALIE A CORLEY 1939 PEBBLEBEACH DECATUR, IL 62521 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 100000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 27 Jan 2025

Sources: Illinois Office of the Secretary of State

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