| Entity Name: | ACTIVE SCREW & FASTENER, LLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Withdrawn |
| Date Formed: | 20 Jun 2016 |
| Company Number: | LLC_05710227 |
| File Number: | 05710227 |
| Type of Management: | Manager Managed |
| Date Status Change: | 28 May 2021 |
| Address | 13725 SOUTH POINT BLVD, CHARLOTTE, 28273, NC |
| Place of Formation: | NORTH CAROLINA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ACTIVE SCREW & FASTENER 401(K) PLAN | 2015 | 362174994 | 2016-12-12 | ACTIVE SCREW & FASTENER | 29 | |||||||||||||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2016-12-12 |
| Name of individual signing | SIMON J BLATTNER, III |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2016-12-12 |
| Name of individual signing | SIMON J BLATTNER, III |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1992-01-01 |
| Business code | 332900 |
| Sponsor’s telephone number | 8479670800 |
| Plan sponsor’s address | 5215 OLD ORCHARD RD., SUITE 700, SKOKIE, IL, 60077 |
Plan administrator’s name and address
| Administrator’s EIN | 362174994 |
| Plan administrator’s name | ACTIVE SCREW & FASTENER |
| Plan administrator’s address | 5215 OLD ORCHARD RD., SUITE 700, SKOKIE, IL, 60077 |
| Administrator’s telephone number | 8479670800 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-22 |
| Name of individual signing | SIMON BLATTNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-06-22 |
| Name of individual signing | SIMON BLATTNER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1992-01-01 |
| Business code | 332900 |
| Sponsor’s telephone number | 8479670800 |
| Plan sponsor’s address | 5215 OLD ORCHARD RD., SUITE 700, SKOKIE, IL, 60077 |
Plan administrator’s name and address
| Administrator’s EIN | 362174994 |
| Plan administrator’s name | ACTIVE SCREW & FASTENER |
| Plan administrator’s address | 5215 OLD ORCHARD RD., SUITE 700, SKOKIE, IL, 60077 |
| Administrator’s telephone number | 8479670800 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-24 |
| Name of individual signing | SIMON BLATTNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-06-24 |
| Name of individual signing | SIMON BLATTNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| KYLE MILLER, 5422 DANSHER RD, COUNTRYSIDE, 60525, COOK-NOT IN CITY OF CHICAGO | Agent | 2019-10-23 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| MILLER, MIKEL D., 13725 SOUTH POINT BLVD, CHARLOTTE, NC, 28273 | Manager | 2020-08-27 |
Date of last update: 27 Jan 2025
