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KERI POWELL THERAPY, INC.

Company Details

Entity Name: KERI POWELL THERAPY, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 07 Dec 2011
Company Number: CORP_68082234
File Number: 68082234
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KERI POWELL THERAPY, INC. 401(K) PLAN 2023 454058427 2024-07-30 KERI POWELL THERAPY, INC. 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621112
Sponsor’s telephone number 2173520200
Plan sponsor’s address 2125 S NEIL ST, CHAMPAIGN, IL, 61820

Signature of

Role Plan administrator
Date 2024-07-30
Name of individual signing JOHN ANSAY
Valid signature Filed with authorized/valid electronic signature
KERI POWELL THERAPY INC. 401(K) PLAN 2022 454058427 2023-07-26 KERI POWELL THERAPY INC. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621112
Sponsor’s telephone number 2173520200
Plan sponsor’s address 2125 S. NEIL STREET, CHAMPAIGN, IL, 61820

Signature of

Role Plan administrator
Date 2023-07-26
Name of individual signing KERI POWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-26
Name of individual signing KERI POWELL
Valid signature Filed with authorized/valid electronic signature
KERI POWELL THERAPY INC. 401(K) PLAN 2021 454058427 2022-09-20 KERI POWELL THERAPY INC. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621112
Sponsor’s telephone number 2173520200
Plan sponsor’s address 701 DEVONSHIRE DRIVE SUITE B1, CHAMPAIGN, IL, 61820

Signature of

Role Plan administrator
Date 2022-09-20
Name of individual signing KERI POWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-20
Name of individual signing KERI POWELL
Valid signature Filed with authorized/valid electronic signature
KERI POWELL THERAPY INC. 401(K) PLAN 2020 454058427 2021-07-16 KERI POWELL THERAPY INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621112
Sponsor’s telephone number 2173520200
Plan sponsor’s address 701 DEVONSHIRE DRIVE SUITE B1, CHAMPAIGN, IL, 61820

Signature of

Role Plan administrator
Date 2021-07-16
Name of individual signing KERI POWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-16
Name of individual signing KERI POWELL
Valid signature Filed with authorized/valid electronic signature
KERI POWELL THERAPY INC. 401(K) PLAN 2019 454058427 2020-10-09 KERI POWELL THERAPY INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621112
Sponsor’s telephone number 2173520200
Plan sponsor’s address 701 DEVONSHIRE DRIVE SUITE B1, CHAMPAIGN, IL, 61820

Signature of

Role Plan administrator
Date 2020-10-09
Name of individual signing KERI POWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-09
Name of individual signing KERI POWELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
KERI B POWELL, 7 DUNLAP CT, SAVOY, 61874, CHAMPAIGN Agent 2020-11-06

President

Name and Address Role
KERI POWELL, 7 DUNLAP CT. SAVOY, IL 61874 President

Secretary

Name and Address Role
NONE Secretary

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 1500 1000000 No data

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State