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  5. SCOTT JACKSON INSURANCE AGENCY INC.

SCOTT JACKSON INSURANCE AGENCY INC.

Company Details

Entity Name: SCOTT JACKSON INSURANCE AGENCY INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 03 Jan 2001
Company Number: CORP_61389571
File Number: 61389571
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SCOTT JACKSON RETIREMENT PLAN 2023 371404798 2024-05-28 SCOTT JACKSON INSURANCE AGENCY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 2173599335
Plan sponsor’s address 3123 VILLAGE OFFICE PLACE, CHAMPAIGN, IL, 61822

Signature of
Role Plan administrator
Date 2024-05-28
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
SCOTT JACKSON RETIREMENT PLAN 2022 371404798 2023-07-05 SCOTT JACKSON INSURANCE AGENCY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 2173599335
Plan sponsor’s address 3123 VILLAGE OFFICE PLACE, CHAMPAIGN, IL, 61822

Signature of
Role Plan administrator
Date 2023-07-05
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
SCOTT JACKSON RETIREMENT PLAN 2021 371404798 2022-05-23 SCOTT JACKSON INSURANCE AGENCY 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 2173599335
Plan sponsor’s address 3123 VILLAGE OFFICE PLAZA, CHAMPAIGN, IL, 61822
SCOTT JACKSON RETIREMENT PLAN 2020 371404798 2021-07-07 SCOTT JACKSON INSURANCE AGENCY 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 2173599335
Plan sponsor’s address 3123 VILLAGE OFFICE PLAZA, CHAMPAIGN, IL, 61822
SCOTT JACKSON RETIREMENT PLAN 2019 371404798 2020-07-08 SCOTT JACKSON INSURANCE AGENCY 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 2173599335
Plan sponsor’s address 3123 VILLAGE OFFICE PLAZA, CHAMPAIGN, IL, 61822

Signature of
Role Plan administrator
Date 2020-07-08
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-08
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
SCOTT JACKSON RETIREMENT PLAN 2018 371404798 2019-06-21 SCOTT JACKSON INSURANCE AGENCY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 2173599335
Plan sponsor’s address 3123 VILLAGE OFFICE PLAZA, CHAMPAIGN, IL, 61822

Signature of
Role Plan administrator
Date 2019-05-06
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-06
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
SCOTT JACKSON RETIREMENT PLAN 2017 371404798 2018-05-01 SCOTT JACKSON INSURANCE AGENCY 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 2173599335
Plan sponsor’s address 3123 VILLAGE OFFICE PLAZA, CHAMPAIGN, IL, 61822

Signature of
Role Plan administrator
Date 2018-05-01
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-01
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
SCOTT JACKSON RETIREMENT PLAN 2016 371404798 2017-03-01 SCOTT JACKSON INSURANCE AGENCY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 2173599335
Plan sponsor’s address 3123 VILLAGE OFFICE PLAZA, CHAMPAIGN, IL, 61822

Signature of
Role Plan administrator
Date 2017-03-01
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-03-01
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
SCOTT JACKSON RETIREMENT PLAN 2015 371404798 2016-07-12 SCOTT JACKSON INSURANCE AGENCY 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 524210
Sponsor’s telephone number 2173599335
Plan sponsor’s address 3123 VILLAGE OFFICE PLAZA, CHAMPAIGN, IL, 61822

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-12
Name of individual signing SCOTT JACKSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
SCOTT L JACKSON, 506 E JEFFERSON ST, PO BOX 202, PHILO, 61864, CHAMPAIGN Agent 2001-01-03

President

Name and Address Role
SCOTT JACKSON, 506 E JEFFERSONBOX 202 PHILO 61864 President

Secretary

Name and Address Role
SCOTT JACKSON, 506 E JEFFERSONBOX 202 PHILO 61864 Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
A No data Voting Rights 1000 1000000 1

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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