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PINEVIEW OF ROCKFORD, LLC

Company Details

Entity Name: PINEVIEW OF ROCKFORD, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 06 Jan 2005
Company Number: LLC_01389351
File Number: 01389351
Type of Management: Member Managed
Date Status Change: 19 Dec 2024
Address 1827 W. MAIN, CARBONDALE, 62901, IL
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PINEVIEW OF ROCKFORD 401(K) PLAN 2022 364609707 2024-03-05 PINEVIEW OF ROCKFORD 17
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2024-03-05
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
PINEVIEW OF ROCKFORD 401(K) PLAN 2021 364609707 2023-10-23 PINEVIEW OF ROCKFORD 30
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2023-10-23
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
PINEVIEW OF ROCKFORD 401(K) PLAN 2021 364609707 2022-09-23 PINEVIEW OF ROCKFORD 37
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2022-09-23
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
PINEVIEW OF ROCKFORD 401(K) PLAN 2020 364609707 2021-09-17 PINEVIEW OF ROCKFORD 33
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2021-09-17
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
PINEVIEW OF ROCKFORD 401(K) PLAN 2020 364609707 2022-01-19 PINEVIEW OF ROCKFORD 33
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2022-01-19
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
PINEVIEW OF ROCKFORD 401(K) PLAN 2019 364609707 2020-09-09 PINEVIEW OF ROCKFORD 25
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2020-09-09
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
PINEVIEW OF ROCKFORD 401(K) PLAN 2018 364609707 2020-01-24 PINEVIEW OF ROCKFORD 29
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2020-01-24
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
PINEVIEW OF ROCKFORD 401(K) PLAN 2018 364609707 2020-01-27 PINEVIEW OF ROCKFORD 29
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 535 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2020-01-27
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
PINEVIEW OF ROCKFORD 401(K) PLAN 2017 364609707 2019-11-20 PINEVIEW OF ROCKFORD 28
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 385 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2019-11-20
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
PINEVIEW OF ROCKFORD 401(K) PLAN 2017 364609707 2018-10-05 PINEVIEW OF ROCKFORD 28
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 623000
Sponsor’s telephone number 8158021400
Plan sponsor’s address 385 E. NORTH STREET, SUITE E, BRADLEY, IL, 60915

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2018-10-05
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
JOHN PAUL BUDSLICK, 1116 W MAIN ST, CARBONDALE, 62901, JEFFERSON Agent 2024-07-29

Manager

Name and Address Role Appointment Date
PINEVIEW OF ROCKFORD GP MEMBER LLC, 1719 W MAIN ST, CARBONDALE, IL, 62901 Manager 2024-12-19

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State