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EFFINGHAM BUILDERS SUPPLY, INC.

Company Details

Entity Name: EFFINGHAM BUILDERS SUPPLY, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 31 Dec 1991
Company Number: CORP_56662499
File Number: 56662499
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EFFINGHAM BUILDERS SUPPLY, INC. 401(K) PLAN 2023 371287109 2024-04-09 EFFINGHAM BUILDERS SUPPLY, INC. 39
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-03-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address 100 E. EVERGREEN, EFFINGHAM, IL, 62401

Signature of

Role Plan administrator
Date 2024-04-09
Name of individual signing WILLIAM METTE
Valid signature Filed with authorized/valid electronic signature
EFFINGHAM BUILDERS SUPPLY INC. MEDOVA LIFESTYLE HEALTH PLAN 2022 371287109 2024-01-07 EFFINGHAM BUILDERS SUPPLY INC. 0
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address PO BOX 249, EFFINGHAM, IL, 624010249

Plan administrator’s name and address

Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT, INC.
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of

Role Plan administrator
Date 2024-01-07
Name of individual signing ROBERT MOORE
Valid signature Filed with authorized/valid electronic signature
EFFINGHAM BUILDERS SUPPLY, INC. 401(K) PLAN 2022 371287109 2023-10-03 EFFINGHAM BUILDERS SUPPLY, INC. 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-03-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address 100 E. EVERGREEN, EFFINGHAM, IL, 62401

Signature of

Role Plan administrator
Date 2023-10-03
Name of individual signing WILLIAM METTE
Valid signature Filed with authorized/valid electronic signature
EFFINGHAM BUILDERS SUPPLY, INC. 401(K) PLAN 2021 371287109 2022-05-03 EFFINGHAM BUILDERS SUPPLY, INC. 34
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-03-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address 100 E. EVERGREEN, EFFINGHAM, IL, 62401

Signature of

Role Plan administrator
Date 2022-05-03
Name of individual signing WILLIAM METTE
Valid signature Filed with authorized/valid electronic signature
EFFINGHAM BUILDERS SUPPLY INC. MEDOVA LIFESTYLE HEALTH PLAN 2021 371287109 2022-09-30 EFFINGHAM BUILDERS SUPPLY INC. 22
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address PO BOX 249, EFFINGHAM, IL, 624010249

Plan administrator’s name and address

Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT INC
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of

Role Plan administrator
Date 2022-09-29
Name of individual signing ROBERT MOORE
Valid signature Filed with authorized/valid electronic signature
EFFINGHAM BUILDERS SUPPLY, INC. 401(K) PLAN 2020 371287109 2021-02-04 EFFINGHAM BUILDERS SUPPLY, INC. 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-03-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address 100 E. EVERGREEN, EFFINGHAM, IL, 62401

Signature of

Role Plan administrator
Date 2021-02-04
Name of individual signing WILLIAM METTE
Valid signature Filed with authorized/valid electronic signature
EFFINGHAM BUILDERS SUPPLY, INC. 401(K) PLAN 2019 371287109 2020-02-10 EFFINGHAM BUILDERS SUPPLY, INC. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-03-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address 100 E. EVERGREEN, EFFINGHAM, IL, 62401

Signature of

Role Plan administrator
Date 2020-02-10
Name of individual signing WILLIAM METTE
Valid signature Filed with authorized/valid electronic signature
EFFINGHAM BUILDERS SUPPLY, INC. 401(K) PLAN 2018 371287109 2019-01-31 EFFINGHAM BUILDERS SUPPLY, INC. 37
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-03-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address 100 E. EVERGREEN, EFFINGHAM, IL, 62401

Signature of

Role Plan administrator
Date 2019-01-31
Name of individual signing WILLIAM G. METTE
Valid signature Filed with authorized/valid electronic signature
EFFINGHAM BUILDERS SUPPLY, INC. 401(K) PLAN 2017 371287109 2018-05-30 EFFINGHAM BUILDERS SUPPLY, INC. 33
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-03-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address 100 E. EVERGREEN, EFFINGHAM, IL, 62401

Signature of

Role Plan administrator
Date 2018-05-30
Name of individual signing WILLIAM G. METTE
Valid signature Filed with authorized/valid electronic signature
EFFINGHAM BUILDERS SUPPLY, INC. 401(K) PLAN 2016 371287109 2017-08-25 EFFINGHAM BUILDERS SUPPLY, INC. 33
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-03-01
Business code 444110
Sponsor’s telephone number 2173470561
Plan sponsor’s address 100 E. EVERGREEN, EFFINGHAM, IL, 62401

Signature of

Role Plan administrator
Date 2017-08-25
Name of individual signing WILLIAM G. METTE
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
Q ANTHONY SIEMER, 1901 S 4TH ST STE 203, EFFINGHAM, 62401, EFFINGHAM Agent 2020-09-21

Secretary

Name and Address Role
WILLIAM G. METTE 709 N. GLENWOOD, EFFINGHAMM IL 62401 Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 10000 10000000 No data

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State