| Entity Name: | MIDWEST INSURANCE AGENCY LLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Goodstanding |
| Date Formed: | 07 Nov 2022 |
| Company Number: | LLC_12458673 |
| File Number: | 12458673 |
| Type of Management: | Manager Managed |
| Date Status Change: | 24 Oct 2024 |
| Address | 1301 EAST HIGGINS ROAD, ELK GROVE VILLAGE, 60007, IL |
| Place of Formation: | ILLINOIS |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | MIDWEST INSURANCE AGENCY LLC, MISSISSIPPI | 1424840 | MISSISSIPPI |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIDWEST INSURANCE AGENCY, LLC 401(K) PLAN | 2023 | 920953871 | 2024-10-12 | MIDWEST INSURANCE AGENCY, LLC | 24 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-12 |
| Name of individual signing | TOM HAMMOND |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-10-12 |
| Name of individual signing | TOM HAMMOND |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-01-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 6304722300 |
| Plan sponsor’s address | 1301 E. HIGGINS ROAD, ELK GROVE VILLAGE, IL, 60007 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-06 |
| Name of individual signing | TOM HAMMOND |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-10-06 |
| Name of individual signing | TOM HAMMOND |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-01-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 6304722300 |
| Plan sponsor’s address | 1301 E. HIGGINS ROAD, ELK GROVE VILLAGE, IL, 60007 |
Signature of
| Role | Plan administrator |
| Date | 2024-02-01 |
| Name of individual signing | THOMAS HAMMOND |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-02-01 |
| Name of individual signing | THOMAS HAMMOND |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| LEE F. DEWALD, 1237 S ARLINGTON HEIGHTS RD, ARLINGTON HEIGHTS, 60005 | Agent | 2022-11-07 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| HAMMOND, THOMAS N., 1301 EAST HIGGINS ROAD, ELK GROVE VILLAGE, IL, 60007 | Manager | 2024-10-24 |
| Name | Change Date |
|---|---|
| MIDWEST INSURANCE AGENCY HOLDINGS LLC | 2023-01-12 |
Date of last update: 13 Jan 2025
