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Will R. Crouch, M.D., P.C.

Details

Name: Will R. Crouch, M.D., P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 12 Feb 1986 (39 years ago)
Date of dissolution: 30 Dec 2019
Entity Number: 000-108-808
Register Number: 000108808
Place of Formation: Morgan County
Principal Address: HARTSELLE, AL
Registered Office Street Address: 300 WEST PINE STHARTSELLE, AL
Authorized Capital: $1,000

Activities MEDICINE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2015 630921944 2016-05-17 WILL R. CROUCH, M.D., P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2567739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Signature of

Role Plan administrator
Date 2016-05-17
Name of individual signing WILL R. CROUCH, MD
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2014 630921944 2015-06-29 WILL R. CROUCH, M.D., P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2567739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Signature of

Role Plan administrator
Date 2015-06-29
Name of individual signing WILL R. CROUCH, MD
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2013 630921944 2014-03-19 WILL R. CROUCH, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2567739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Signature of

Role Plan administrator
Date 2014-03-19
Name of individual signing WILL R. CROUCH, MD
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2012 630921944 2013-09-18 WILL R. CROUCH, M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2567739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Signature of

Role Plan administrator
Date 2013-09-18
Name of individual signing WILL R. CROUCH, MD
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2011 630921944 2012-09-19 WILL R. CROUCH, M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2567739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Plan administrator’s name and address

Administrator’s EIN 630921944
Plan administrator’s name WILL R. CROUCH, M.D., P.C.
Plan administrator’s address 301 PINE STREET SW, HARTSELLE, AL, 35640
Administrator’s telephone number 2567739089

Signature of

Role Plan administrator
Date 2012-09-19
Name of individual signing WILL CROUCH
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2010 630921944 2011-10-17 WILL R. CROUCH, M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2057739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Plan administrator’s name and address

Administrator’s EIN 630921944
Plan administrator’s name WILL R. CROUCH, M.D., P.C.
Plan administrator’s address 301 PINE STREET SW, HARTSELLE, AL, 35640
Administrator’s telephone number 2057739089

Signature of

Role Plan administrator
Date 2011-10-17
Name of individual signing WILL R. CROUCH, MD
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2010 630921944 2011-10-14 WILL R. CROUCH, M.D., P.C. 5
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2057739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Plan administrator’s name and address

Administrator’s EIN 630921944
Plan administrator’s name WILL R. CROUCH, M.D., P.C.
Plan administrator’s address 301 PINE STREET SW, HARTSELLE, AL, 35640
Administrator’s telephone number 2057739089

Signature of

Role Plan administrator
Date 2011-10-14
Name of individual signing WILL R. CROUCH, MD
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2009 630921944 2010-07-20 WILL R. CROUCH, M.D., P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2057739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Plan administrator’s name and address

Administrator’s EIN 630921944
Plan administrator’s name WILL R. CROUCH, M.D., P.C.
Plan administrator’s address 301 PINE STREET SW, HARTSELLE, AL, 35640
Administrator’s telephone number 2057739089

Signature of

Role Plan administrator
Date 2010-07-19
Name of individual signing WILL R. CROUCH, MD
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2009 630921944 2010-07-13 WILL R. CROUCH, M.D., P.C. 4
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2057739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Plan administrator’s name and address

Administrator’s EIN 630921944
Plan administrator’s name WILL R. CROUCH, M.D., P.C.
Plan administrator’s address 301 PINE STREET SW, HARTSELLE, AL, 35640
Administrator’s telephone number 2057739089

Signature of

Role Plan administrator
Date 2010-07-13
Name of individual signing KENT QUINN
WILL R. CROUCH, M.D. P.C. PROFIT SHARING PLAN 2009 630921944 2010-07-12 WILL R. CROUCH, M.D., P.C. 4
Three-digit plan number (PN) 001
Effective date of plan 1986-02-01
Business code 621111
Sponsor’s telephone number 2057739089
Plan sponsor’s address 301 PINE STREET SW, HARTSELLE, AL, 35640

Plan administrator’s name and address

Administrator’s EIN 630921944
Plan administrator’s name WILL R. CROUCH, M.D., P.C.
Plan administrator’s address 301 PINE STREET SW, HARTSELLE, AL, 35640
Administrator’s telephone number 2057739089

Signature of

Role Plan administrator
Date 2010-07-12
Name of individual signing WILL R. CROUCH, MD
Role Employer/plan sponsor
Date 2010-07-12
Name of individual signing WILL R. CROUCH, MD

Agent

Name Role
CROUCH, WILL R Agent

Incorporator

Name Role
CROUCH, WILL R Incorporator

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State