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CLEAN USA, INC.

Company Details

Entity Name: CLEAN USA, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 15 Mar 2013
Company Number: CORP_68952697
File Number: 68952697
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLEAN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2023 300782350 2024-04-08 CLEAN USA INC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 561740
Sponsor’s telephone number 6308360088
Plan sponsor’s address 1630 DEKALB AVE, SYCAMORE, IL, 60178

Signature of

Role Plan administrator
Date 2024-04-08
Name of individual signing THERESA HOLTERHAUS
Valid signature Filed with authorized/valid electronic signature
CLEAN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2022 300782350 2023-08-30 CLEAN USA INC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 561740
Sponsor’s telephone number 6308360088
Plan sponsor’s address 1630 DEKALB AVE, SYCAMORE, IL, 60178

Signature of

Role Plan administrator
Date 2023-08-30
Name of individual signing THERESA HOLTERHAUS
Valid signature Filed with authorized/valid electronic signature
CLEAN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2021 300782350 2022-09-22 CLEAN USA INC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 561740
Sponsor’s telephone number 6308360088
Plan sponsor’s address 920 WEST PRAIRIE DRIVE - SUITE M, SYCAMORE, IL, 60178

Signature of

Role Plan administrator
Date 2022-09-22
Name of individual signing JUSTIN ELLIOTT
Valid signature Filed with authorized/valid electronic signature
CLEAN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2020 300782350 2021-04-21 CLEAN USA INC 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 561740
Sponsor’s telephone number 6308360088
Plan sponsor’s address 920 WEST PRAIRIE DRIVE - SUITE M, SYCAMORE, IL, 60178

Signature of

Role Plan administrator
Date 2021-04-21
Name of individual signing THERESA HOLTERHAUS
Valid signature Filed with authorized/valid electronic signature
CLEAN USA INC 401(K) PROFIT SHARING PLAN & TRUST 2019 300782350 2020-04-07 CLEAN USA INC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 561740
Sponsor’s telephone number 6308360088
Plan sponsor’s address 920 WEST PRAIRIE DRIVE - SUITE M, SYCAMORE, IL, 60178

Signature of

Role Plan administrator
Date 2020-04-07
Name of individual signing THERESA HOLTERHAUS
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JUSTIN ELLIOTT, 920 PRARIE DR STE M, SYCAMORE, 60178, DE KALB Agent 2015-05-12

Secretary

Name and Address Role
JUSTIN ELLIOTT, 1630 DEKALB AVE. SYCAMORE, IL 60178 Secretary

President

Name and Address Role
JUSTIN ELLIOTT, 1630 DEKALB AVE. SYCAMORE, IL 60178 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 1000000 No data

Date of last update: 13 Feb 2025

Sources: Illinois Office of the Secretary of State