| Entity Name: | CARLSON ORTHOPEDIC CLINIC, S.C. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Goodstanding |
| Date Formed: | 02 Feb 1999 |
| Company Number: | CORP_60327785 |
| File Number: | 60327785 |
| Type of Business: | Incorporated under the Medical Corporation Act |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
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| CARLSON ORTHOPEDIC CLINIC, S.C. 401(K) PLAN | 2016 | 364274996 | 2017-10-16 | CARLSON ORTHOPEDIC CLINIC, S.C. | 16 | |||||||||||||||||||||||||||||||
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| CARLSON ORTHOPEDIC CLINIC, S.C. 401(K) PLAN | 2015 | 364274996 | 2016-10-17 | CARLSON ORTHOPEDIC CLINIC, S.C. | 17 | |||||||||||||||||||||||||||||||
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| CARLSON ORTHOPEDIC CLINIC, S.C. 401(K) PLAN | 2013 | 364274996 | 2014-10-15 | CARLSON ORTHOPEDIC CLINIC, S.C. | 17 | |||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2014-10-15 |
| Name of individual signing | MARK CARLSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2006-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8153989100 |
| Plan sponsor’s address | 1848 DAIMLER ROAD, ROCKFORD, IL, 61112 |
Signature of
| Role | Plan administrator |
| Date | 2013-10-14 |
| Name of individual signing | MARK CARLSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2006-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8153989100 |
| Plan sponsor’s address | 1848 DAIMLER ROAD, ROCKFORD, IL, 61112 |
Plan administrator’s name and address
| Administrator’s EIN | 364274996 |
| Plan administrator’s name | CARLSON ORTHOPEDIC CLINIC, S.C. |
| Plan administrator’s address | 1848 DAIMLER ROAD, ROCKFORD, IL, 61112 |
| Administrator’s telephone number | 8153989100 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-13 |
| Name of individual signing | KRISTINE CARLSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2006-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8153989100 |
| Plan sponsor’s address | 1848 DAIMLER ROAD, ROCKFORD, IL, 61112 |
Plan administrator’s name and address
| Administrator’s EIN | 364274996 |
| Plan administrator’s name | CARLSON ORTHOPEDIC CLINIC, S.C. |
| Plan administrator’s address | 1848 DAIMLER ROAD, ROCKFORD, IL, 61112 |
| Administrator’s telephone number | 8153989100 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-10 |
| Name of individual signing | KRISTINE CARLSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2006-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8153989100 |
| Plan sponsor’s address | 1848 DAIMLER ROAD, ROCKFORD, IL, 61112 |
Plan administrator’s name and address
| Administrator’s EIN | 364274996 |
| Plan administrator’s name | CARLSON ORTHOPEDIC CLINIC, S.C. |
| Plan administrator’s address | 1848 DAIMLER ROAD, ROCKFORD, IL, 61112 |
| Administrator’s telephone number | 8153989100 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-14 |
| Name of individual signing | KRISTINE CARLSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| LUKE CARLSON, 6833 STALTER DR STE 100, ROCKFORD, 61108, WINNEBAGO | Agent | 2024-01-23 |
| Name and Address | Role |
|---|---|
| MARK E CARLSON 4303 MARSH AVEROCKFORD IL 61114 | President |
| Name and Address | Role |
|---|---|
| MARK E CARLSON | Secretary |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 10000 | 1000000 | No data |
Date of last update: 23 Dec 2024
