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  5. HAC, INC.

HAC, INC.

Company Details

Entity Name: HAC, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 15 Mar 2004
Date of Dissolution: 10 Nov 2020
Company Number: CORP_63411442
File Number: 63411442
Type of Business: All Inclusive Purpose
Date Status Change: 10 Nov 2020
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HAC, INC. 401K PROFIT SHARING PLAN 2010 550868762 2011-01-19 HAC, INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-08-01
Business code 446110
Sponsor’s telephone number 2177848545
Plan sponsor’s DBA name DBA THE MEDICINE SHOPPE PHARMACY
Plan sponsor’s address 104 NORTH SANGAMON, GIBSON CITY, IL, 609361343

Plan administrator’s name and address
Administrator’s EIN 550868762
Plan administrator’s name HAC, INC.
Plan administrator’s address 104 NORTH SANGAMON, GIBSON CITY, IL, 609361343
Administrator’s telephone number 2177848545

Signature of
Role Plan administrator
Date 2011-01-19
Name of individual signing DONNA MATTERA
Valid signature Filed with authorized/valid electronic signature
HAC, INC. 401(K) PROFIT SHARING PLAN 2009 550868762 2010-08-10 HAC, INC. 5
Three-digit plan number (PN) 001
Effective date of plan 2004-08-01
Business code 446110
Sponsor’s telephone number 2177848545
Plan sponsor’s address 104 NORTH SANGAMON, GIBSON CITY, IL, 60936

Plan administrator’s name and address
Administrator’s EIN 550868762
Plan administrator’s name HAC, INC.
Plan administrator’s address 104 NORTH SANGAMON, GIBSON CITY, IL, 60936
Administrator’s telephone number 2177848545

Signature of
Role Plan administrator
Date 2010-08-10
Name of individual signing DONNA MATTERA
Valid signature Filed with incorrect/unrecognized electronic signature
HAC, INC. 401K PROFIT SHARING PLAN 2009 550868762 2011-01-19 HAC, INC. 5
Three-digit plan number (PN) 001
Effective date of plan 2004-08-01
Business code 446110
Sponsor’s telephone number 2177848545
Plan sponsor’s DBA name DBA THE MEDICINE SHOPPE PHARMACY
Plan sponsor’s address 104 NORTH SANGAMON, GIBSON CITY, IL, 609361343

Plan administrator’s name and address
Administrator’s EIN 550868762
Plan administrator’s name HAC, INC.
Plan administrator’s address 104 NORTH SANGAMON, GIBSON CITY, IL, 609361343
Administrator’s telephone number 2177848545

Signature of
Role Plan administrator
Date 2011-01-19
Name of individual signing DONNA MATTERA
Valid signature Filed with authorized/valid electronic signature
HAC, INC. 401(K) PROFIT SHARING PLAN 2009 550868762 2010-10-11 HAC, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-08-01
Business code 446110
Sponsor’s telephone number 2177848545
Plan sponsor’s address 104 NORTH SANGAMON, GIBSON CITY, IL, 60936

Plan administrator’s name and address
Administrator’s EIN 550868762
Plan administrator’s name HAC, INC.
Plan administrator’s address 104 NORTH SANGAMON, GIBSON CITY, IL, 60936
Administrator’s telephone number 2177848545

Signature of
Role Plan administrator
Date 2010-10-11
Name of individual signing DONNA MATTERA
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
DONNA MATTERA, 104 N SANGAMON, GIBSON CITY, 60936, FORD Agent 2004-03-15

President

Name and Address Role
DONNA MATTERA, 7513 SOUTHPORTLANE, SPRINGFIELD President

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
HEALTH ONE OF CENTRAL ILLINOIS No data 2005-02-22 2005-12-19 Voluntary Cancellation No data
MEDICINE SHOPPE PHARMACY OF GIBSON CITY No data 2005-02-22 2010-08-02 Involuntary Cancellation No data

Shares

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

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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