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  5. THE CARLTON AT THE LAKE, INC.

THE CARLTON AT THE LAKE, INC.

Company Details

Entity Name: THE CARLTON AT THE LAKE, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 13 May 1980
Company Number: CORP_52057051
File Number: 52057051
Address 725 W MONTROSE AVE 1ST, CHICAGO, IL, 60613
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CARLTON AT THE LAKE, INC. PROFIT SHARING PLAN 2016 363075919 2019-01-02 CARLTON AT THE LAKE, INC. 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 812990
Sponsor’s telephone number 8476799141
Plan sponsor’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712
CARLTON AT THE LAKE, INC. PROFIT SHARING PLAN 2015 363075919 2016-09-28 CARLTON AT THE LAKE, INC. 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 812990
Sponsor’s telephone number 8476799141
Plan sponsor’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712

Signature of
Role Plan administrator
Date 2016-09-28
Name of individual signing JAMES T SLESUR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-28
Name of individual signing JAMES T SLESUR
Valid signature Filed with authorized/valid electronic signature
CARLTON AT THE LAKE, INC. PROFIT SHARING PLAN 2014 363075919 2015-09-25 CARLTON AT THE LAKE, INC. 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 812990
Sponsor’s telephone number 8476799141
Plan sponsor’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712

Signature of
Role Plan administrator
Date 2015-09-25
Name of individual signing JAMES SLESUR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-25
Name of individual signing JAMES SLESUR
Valid signature Filed with authorized/valid electronic signature
CARLTON AT THE LAKE, INC. PROFIT SHARING PLAN 2013 363075919 2014-09-11 CARLTON AT THE LAKE, INC. 82
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 812990
Sponsor’s telephone number 8476799141
Plan sponsor’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712

Signature of
Role Plan administrator
Date 2014-09-11
Name of individual signing JAMES SLESUR
Valid signature Filed with authorized/valid electronic signature
CARLTON AT THE LAKE, INC. PROFIT SHARING PLAN 2012 363075919 2013-05-15 CARLTON AT THE LAKE, INC. 72
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 812990
Sponsor’s telephone number 8476799141
Plan sponsor’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712

Signature of
Role Plan administrator
Date 2013-05-14
Name of individual signing JAMES SLESUR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-14
Name of individual signing JAMES SLESUR
Valid signature Filed with authorized/valid electronic signature
CARLTON AT THE LAKE, INC. PROFIT SHARING PLAN 2011 363075919 2012-08-01 CARLTON AT THE LAKE, INC. 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 812990
Sponsor’s telephone number 8476799141
Plan sponsor’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712

Plan administrator’s name and address
Administrator’s EIN 363075919
Plan administrator’s name CARLTON AT THE LAKE, INC.
Plan administrator’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712
Administrator’s telephone number 8476799141

Signature of
Role Plan administrator
Date 2012-08-01
Name of individual signing JAMES SLESUR
Valid signature Filed with authorized/valid electronic signature
CARLTON AT THE LAKE, INC. PROFIT SHARING PLAN 2010 363075919 2011-06-07 CARLTON AT THE LAKE, INC. 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 812990
Sponsor’s telephone number 8476799141
Plan sponsor’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712

Plan administrator’s name and address
Administrator’s EIN 363075919
Plan administrator’s name CARLTON AT THE LAKE, INC.
Plan administrator’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712
Administrator’s telephone number 8476799141

Signature of
Role Plan administrator
Date 2011-06-07
Name of individual signing JAMES SLESUR
Valid signature Filed with authorized/valid electronic signature
CARLTON AT THE LAKE, INC. PROFIT SHARING PLAN 2009 363075919 2010-10-04 CARLTON AT THE LAKE, INC. 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 812990
Sponsor’s telephone number 8476799141
Plan sponsor’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712

Plan administrator’s name and address
Administrator’s EIN 363075919
Plan administrator’s name CARLTON AT THE LAKE, INC.
Plan administrator’s address 6633 NORTH LINCOLN AVENUE, LINCOLNWOOD, IL, 60712
Administrator’s telephone number 8476799141

Signature of
Role Plan administrator
Date 2010-10-04
Name of individual signing JAMES SLESUR
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SHELDON HOLLANDER, 6633 N LINCOLN AVE, LINCOLNWOOD, 60712, COOK-NOT IN CITY OF CHICAGO Agent 2019-03-01

President

Name and Address Role Account Number
MOSHE RAJCHENBACH 6633 N LINCOLN AVE LICOLNWOOD IL, 60712 President No data
JACK L RAJCHENBACH President 14393

Secretary

Name and Address Role Account Number
AS ABOVE Secretary No data
BERNARD B HOLLANDER Secretary 14393

License

License Type License Number Status License Code License Description Business Activity Date Issued Effective Date Expiration Date
BUSINESS LICENSE 2204338 Issued 4404 Regulated Business License 699 - Long Term Care Facility 2014-06-03 2014-06-16 2016-06-15
BUSINESS LICENSE 31679 Cancelled 1005 Long-Term Care Facility No data 2012-08-30 2012-06-16 2014-06-15

Historical Names

Name Change Date
C. H. NURSING CENTER, INC. 1991-10-24

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Rights Unknown 100000 1000000 1

Related by officers

AS ABOVE

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SHELDON HOLLANDER, 6633 N LINCOLN AVE, LINCOLNWOOD, 60712, COOK-NOT IN CITY OF CHICAGO

RAJCHENBACH GLENVIEW TERRACE, LLC HARMONY NURSING AND REHABILITATION CENTER, INC. CHASDEI AVOS OF ILLINOIS INC

JACK L RAJCHENBACH

HALSTED TERRACE NURSING CENTER, INC.

BERNARD B HOLLANDER

HALSTED TERRACE NURSING CENTER, INC.

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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