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BLEVINS INSURANCE AGENCY, INC.

Company Details

Entity Name: BLEVINS INSURANCE AGENCY, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Goodstanding
Date Formed: 02 Nov 2023
Company Number: CORP_74432301
File Number: 74432301
Type of Business: All Inclusive Purpose
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLEVINS INSURANCE AGENCY 401(K) PLAN 2023 934214402 2024-05-10 BLEVINS INSURANCE AGENCY INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-01-01
Business code 524210
Sponsor’s telephone number 7793452886
Plan sponsor’s address 6156 E RIVERSIDE BLVD, LOVES PARK, IL, 61111

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2024-05-10
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
ANDREW BLEVINS, 6156 E RIVERSIDE BLVD, LOVES PARK, 61111, WINNEBAGO Agent 2023-11-02

Incorporator

Name and Address Role
ANDREW BLEVINS Incorporator

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMMON No data Voting Rights 100 100000 No data

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State