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  5. CENTRAL ILLINOIS X-RAY, INC.

CENTRAL ILLINOIS X-RAY, INC.

Company Details

Entity Name: CENTRAL ILLINOIS X-RAY, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 06 May 2016
Company Number: CORP_70702134
File Number: 70702134
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CENTRAL ILLINOIS X-RAY INC. 401K PLAN 2023 810939614 2024-04-09 CENTRAL ILLINOIS X-RAY INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-08-17
Business code 541990
Sponsor’s telephone number 3098297223
Plan sponsor’s address 501 SOUTH MCCLUN STREET, BLOOMINGTON, IL, 61701

Signature of
Role Plan administrator
Date 2024-04-09
Name of individual signing DAWN PATTON
Valid signature Filed with authorized/valid electronic signature
CENTRAL ILLINOIS X-RAY INC. 401K PLAN 2022 810939614 2023-10-05 CENTRAL ILLINOIS X-RAY INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-08-17
Business code 541990
Sponsor’s telephone number 3098297223
Plan sponsor’s address 501 S MCCLUN, BLOOMINGTON, IL, 61701

Signature of
Role Plan administrator
Date 2023-10-05
Name of individual signing DAWN PATTON
Valid signature Filed with authorized/valid electronic signature
CENTRAL ILLINOIS X-RAY INC. 401K PLAN 2021 810939614 2022-10-04 CENTRAL ILLINOIS X-RAY INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-08-17
Business code 541990
Sponsor’s telephone number 3098297223
Plan sponsor’s address 501 S MCCLUN, BLOOMINGTON, IL, 61701

Signature of
Role Plan administrator
Date 2022-10-04
Name of individual signing DAWN PATTON
Valid signature Filed with authorized/valid electronic signature
CENTRAL ILLINOIS X-RAY INC. 401K PLAN 2020 810939614 2021-12-23 CENTRAL ILLINOIS X-RAY INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-08-17
Business code 541990
Sponsor’s telephone number 3098297223
Plan sponsor’s address 501 S MCCLUN, BLOOMINGTON, IL, 61701

Signature of
Role Plan administrator
Date 2021-12-23
Name of individual signing DAWN PATTON
Valid signature Filed with authorized/valid electronic signature
CENTRAL ILLINOIS X-RAY INC. 401K PLAN 2020 810939614 2021-10-06 CENTRAL ILLINOIS X-RAY INC. 8
Three-digit plan number (PN) 001
Effective date of plan 2007-08-17
Business code 541990
Sponsor’s telephone number 3098297223
Plan sponsor’s address 501 S MCCLUN, BLOOMINGTON, IL, 61701

Signature of
Role Plan administrator
Date 2021-10-06
Name of individual signing DAWN PATTON
Valid signature Filed with authorized/valid electronic signature
CENTRAL ILLINOIS X-RAY INC. 401K PLAN 2019 810939614 2020-07-07 CENTRAL ILLINOIS X-RAY INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-08-17
Business code 541990
Sponsor’s telephone number 3098297223
Plan sponsor’s address 501 S MCCLUN, BLOOMINGTON, IL, 61701

Signature of
Role Plan administrator
Date 2020-07-07
Name of individual signing DAWN PATTON
Valid signature Filed with authorized/valid electronic signature
CENTRAL ILLINOIS X-RAY INC. 401K PLAN 2018 810939614 2019-09-16 CENTRAL ILLINOIS X-RAY INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-08-17
Business code 541990
Sponsor’s telephone number 3098297223
Plan sponsor’s address 501 S MCCLUN, BLOOMINGTON, IL, 61701

Signature of
Role Plan administrator
Date 2019-09-16
Name of individual signing DAWN PATTON
Valid signature Filed with authorized/valid electronic signature
CENTRAL ILLINOIS X-RAY INC. 401K PLAN 2017 810939614 2018-09-19 CENTRAL ILLINOIS X-RAY INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-08-17
Business code 541990
Sponsor’s telephone number 3098297223
Plan sponsor’s address 501 S MCCLUN, BLOOMINGTON, IL, 61701

Signature of
Role Plan administrator
Date 2018-09-19
Name of individual signing DAWN PATTON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ANTHONY W GLIWA, 501 S MCCLUN ST, BLOOMINGTON, 61701, MC LEAN Agent 2021-01-07

President

Name and Address Role
ANTHONY W GLIWA 2909 KINGSBURY CT BLOOMINGTON IL 61704 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 5000 1000000 No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State

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