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  5. PSK SERVICE CORPORATION

PSK SERVICE CORPORATION

Company Details

Entity Name: PSK SERVICE CORPORATION
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 21 Jun 2007
Date of Dissolution: 22 Dec 2016
Company Number: CORP_65616696
File Number: 65616696
Type of Business: All Inclusive Purpose
Date Status Change: 22 Dec 2016
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PSK SIGNATURE RETIREE HEALTH BENEFIT TRUST 2015 260416706 2016-07-27 PSK SERVICE CORPORATION 1
File View Page
Three-digit plan number (PN) 511
Effective date of plan 2009-12-07
Business code 524210
Sponsor’s telephone number 6308342210
Plan sponsor’s address 26152 W DUCK LN, ANTIOCH, IL, 600029206

Signature of
Role Plan administrator
Date 2016-07-27
Name of individual signing NICOLE FALCO WATSON
Valid signature Filed with authorized/valid electronic signature
PSK SIGNATURE RETIREE HEALTH BENEFIT TRUST 2014 260416706 2015-07-07 PSK SERVICE CORPORATION 1
File View Page
Three-digit plan number (PN) 511
Effective date of plan 2009-12-07
Business code 524210
Sponsor’s telephone number 6308342210
Plan sponsor’s address 26152 WEST DUCK LANE, ANTIOCH, IL, 60002

Signature of
Role Plan administrator
Date 2015-07-07
Name of individual signing NICOLE FALCO WATSON
Valid signature Filed with authorized/valid electronic signature
PSK SIGNATURE RETIREE HEALTH BENEFIT TRUST 2013 260416706 2014-07-24 PSK SERVICE CORPORATION 1
File View Page
Three-digit plan number (PN) 511
Effective date of plan 2009-12-07
Business code 524210
Sponsor’s telephone number 6308342210
Plan sponsor’s address 26152 WEST DUCK LANE, ANTIOCH, IL, 60002

Signature of
Role Plan administrator
Date 2014-07-21
Name of individual signing NICOLE FALCO WATSON
Valid signature Filed with authorized/valid electronic signature
PSK SIGNATURE RETIREE HEALTH BENEFIT TRUST 2012 260416706 2013-07-19 PSK SERVICE CORPORATION 1
File View Page
Three-digit plan number (PN) 511
Effective date of plan 2009-12-07
Business code 524210
Sponsor’s telephone number 6308342210
Plan sponsor’s address 26152 WEST DUCK LANE, ANTIOCH, IL, 60002

Signature of
Role Plan administrator
Date 2013-07-19
Name of individual signing NICOLE FALCO WATSON
Valid signature Filed with authorized/valid electronic signature
PSK SIGNATURE RETIREE HEALTH BENEFIT TRUST 2011 260416706 2012-06-05 PSK SERVICE CORPORATION 1
File View Page
Three-digit plan number (PN) 511
Effective date of plan 2009-12-07
Business code 524210
Sponsor’s telephone number 6308342210
Plan sponsor’s address 26152 WEST DUCK LANE, ANTIOCH, IL, 60002

Plan administrator’s name and address
Administrator’s EIN 260416706
Plan administrator’s name PSK SERVICE CORPORATION
Plan administrator’s address 26152 WEST DUCK LANE, ANTIOCH, IL, 60002
Administrator’s telephone number 6308342210

Signature of
Role Plan administrator
Date 2012-06-05
Name of individual signing PAUL DOUCETTE
Valid signature Filed with authorized/valid electronic signature
PSK SIGNATURE RETIREE HEALTH BENEFIT TRUST 2010 260416706 2011-08-01 PSK SERVICE CORPORATION 1
File View Page
Three-digit plan number (PN) 511
Effective date of plan 2009-12-07
Business code 524210
Sponsor’s telephone number 6308342210
Plan sponsor’s address 200 SPRING RD, STE. 511, OAK BROOK, IL, 60523

Plan administrator’s name and address
Administrator’s EIN 260416706
Plan administrator’s name PSK SERVICE CORPORATION
Plan administrator’s address 200 SPRING RD, STE. 511, OAK BROOK, IL, 60523
Administrator’s telephone number 6308342210

Signature of
Role Plan administrator
Date 2011-08-01
Name of individual signing PAUL DOUCETTE
Valid signature Filed with authorized/valid electronic signature
PSK SIGNATURE RETIREE HEALTH BENEFIT TRUST 2009 260416706 2010-07-29 PSK SERVICE CORPORATION 1
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2009-12-07
Business code 524210
Sponsor’s telephone number 6308342210
Plan sponsor’s address 2000 SPRING ROAD STE 511, OAK BROOK, IL, 605231872

Plan administrator’s name and address
Administrator’s EIN 260416706
Plan administrator’s name PSK SERVICE CORPORATION
Plan administrator’s address 2000 SPRING ROAD STE 511, OAK BROOK, IL, 605231872
Administrator’s telephone number 6308342210

Signature of
Role Plan administrator
Date 2010-07-29
Name of individual signing PAUL S KASIK
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
PATRICIA S ZOM-KASIK, 6421 GINOS WAY, FOX LAKE, 60020, LAKE Agent 2016-11-16

President

Name and Address Role
PATRICIA ZORN - KASIK 26152 W DUCK LN ANTIOCH IL 60002 President

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1000 100000 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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