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  5. THEBES HISTORICAL SOCIETY

THEBES HISTORICAL SOCIETY

Company Details

Entity Name: THEBES HISTORICAL SOCIETY
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Dissolved
Date Formed: 17 Sep 1970
Date of Dissolution: 02 Feb 2004
Company Number: CORP_49717792
File Number: 49717792
Date Status Change: 02 Feb 2004
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 401(K) PROFIT-SHARING PLAN & TRUST 2012 370913721 2013-06-19 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, SUITE 209, BLOOMINGTON, IL, 61701

Signature of
Role Plan administrator
Date 2013-06-19
Name of individual signing ROBERT RUSSELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-19
Name of individual signing ROBERT RUSSELL
Valid signature Filed with authorized/valid electronic signature
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. PROFIT-SHARING PLAN 2011 370913721 2012-06-19 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, SUITE 209, BLOOMINGTON, IL, 61701

Plan administrator’s name and address
Administrator’s EIN 370913721
Plan administrator’s name BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD.
Plan administrator’s address 1404 EASTLAND DRIVE, SUITE 209, BLOOMINGTON, IL, 61701
Administrator’s telephone number 3096623277

Signature of
Role Plan administrator
Date 2012-06-19
Name of individual signing ROBERT RUSSELL
Valid signature Filed with authorized/valid electronic signature
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD PROFIT SHARING PLAN 2010 370913721 2011-10-25 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701

Plan administrator’s name and address
Administrator’s EIN 370913721
Plan administrator’s name BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD.
Plan administrator’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701
Administrator’s telephone number 3096623277

Signature of
Role Plan administrator
Date 2011-10-25
Name of individual signing LORI FEATHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-25
Name of individual signing LORI FEATHER
Valid signature Filed with authorized/valid electronic signature
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD PROFIT SHARING PLAN 2009 370913721 2010-12-06 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 13
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701

Plan administrator’s name and address
Administrator’s EIN 370913721
Plan administrator’s name BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD.
Plan administrator’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701
Administrator’s telephone number 3096623277

Signature of
Role Plan administrator
Date 2010-12-06
Name of individual signing THOMAS C. OCHELTREE, M.D.
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-12-06
Name of individual signing THOMAS C. OCHELTREE, M.D.
Valid signature Filed with incorrect/unrecognized electronic signature
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD PROFIT SHARING PLAN 2009 370913721 2011-04-27 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701

Plan administrator’s name and address
Administrator’s EIN 370913721
Plan administrator’s name BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD.
Plan administrator’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701
Administrator’s telephone number 3096623277

Signature of
Role Plan administrator
Date 2011-04-27
Name of individual signing LORI FEATHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-04-27
Name of individual signing LORI FEATHER
Valid signature Filed with authorized/valid electronic signature
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD PROFIT SHARING PLAN 2009 370913721 2010-12-06 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 13
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701

Plan administrator’s name and address
Administrator’s EIN 370913721
Plan administrator’s name BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD.
Plan administrator’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701
Administrator’s telephone number 3096623277

Signature of
Role Plan administrator
Date 2010-12-06
Name of individual signing LORI FEATHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-12-06
Name of individual signing LORI FEATHER
Valid signature Filed with authorized/valid electronic signature
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD PROFIT SHARING PLAN 2009 370913721 2010-12-06 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 13
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701

Plan administrator’s name and address
Administrator’s EIN 370913721
Plan administrator’s name BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD.
Plan administrator’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701
Administrator’s telephone number 3096623277

Signature of
Role Plan administrator
Date 2010-12-06
Name of individual signing LORI FEATHER
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-12-06
Name of individual signing LORI FEATHER
Valid signature Filed with incorrect/unrecognized electronic signature
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD PROFIT SHARING PLAN 2009 370913721 2010-12-06 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 13
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701

Plan administrator’s name and address
Administrator’s EIN 370913721
Plan administrator’s name BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD.
Plan administrator’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701
Administrator’s telephone number 3096623277

Signature of
Role Plan administrator
Date 2010-12-06
Name of individual signing LORI FEATHER
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-12-06
Name of individual signing LORI FEATHER
Valid signature Filed with incorrect/unrecognized electronic signature
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD PROFIT SHARING PLAN 2009 370913721 2010-12-06 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 13
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701

Plan administrator’s name and address
Administrator’s EIN 370913721
Plan administrator’s name BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD.
Plan administrator’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701
Administrator’s telephone number 3096623277

Signature of
Role Plan administrator
Date 2010-12-06
Name of individual signing LORI FEATHER
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-12-06
Name of individual signing LORI FEATHER
Valid signature Filed with incorrect/unrecognized electronic signature
BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD PROFIT SHARING PLAN 2009 370913721 2010-12-06 BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD. 13
Three-digit plan number (PN) 002
Effective date of plan 1970-07-01
Business code 621111
Sponsor’s telephone number 3096623277
Plan sponsor’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701

Plan administrator’s name and address
Administrator’s EIN 370913721
Plan administrator’s name BLOOMINGTON/NORMAL EAR, NOSE & THROAT, LTD.
Plan administrator’s address 1404 EASTLAND DRIVE, BLOOMINGTON, IL, 61701
Administrator’s telephone number 3096623277

Signature of
Role Plan administrator
Date 2010-12-06
Name of individual signing THOMAS C. OCHELTREE, M.D.
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-12-06
Name of individual signing THOMAS C. OCHELTREE, M.D.
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name and Address Role Appointment Date
ELSIE M PULLEY, 201 S 5TH ST POB 14, THEBES, 62990, ALEXANDER Agent 2001-05-25

President

Name and Address Role
SUSAN TUCKER, RT 1 BOX 196 B, THEBES IL 62990 President

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State

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