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  5. Relf Eyecare Specialists, P.A.

Relf Eyecare Specialists, P.A.

Company Details

Name: Relf Eyecare Specialists, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 10 Aug 2000 (24 years ago)
Company Number: 04fe449e-a3d4-e011-a886-001ec94ffe7f
File Number: 11H-233
Registered Office Address: 4413 Air Base Road, Hermantown, MN 55803, USA
Principal Executive Office Address: 4413 AIR BASE RD, HERMANTOWN, MN 55811–1847, USA
ZIP code: 55803
County: St. Louis County
Place of Formation: Minnesota

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
YG1UD561SQD7 2023-04-17 4413 AIR BASE RD, HERMANTOWN, MN, 55811, 1847, USA 4413 AIR BASE RD, HERMANTOWN, MN, 55811, USA

Business Information
Congressional District 08
State/Country of Incorporation MN, USA
Activation Date 2022-03-22
Initial Registration Date 2022-03-03
Entity Start Date 2000-10-01
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name MISSY PAVLOWICH
Role BUSINESS OFFICE
Address 4413 AIRBASE ROAD, HERMANTOWN, MN, 55811, USA
Government Business
Title PRIMARY POC
Name JODI NELSON
Role ADMINISTRATOR
Address 4413 AIRBASE ROAD, HERMANTOWN, MN, 55811, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RELF EYECARE SPECIALISTS, P.A. 401(K) 2023 411982173 2024-08-01 RELF EYECARE SPECIALISTS, P.A. 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIR BASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2024-08-01
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-08-01
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
RELF EYECARE SPECIALISTS, P.A. 401(K) 2022 411982173 2023-06-30 RELF EYECARE SPECIALISTS, P.A. 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIR BASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2023-06-30
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-06-30
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
RELF EYECARE SPECIALISTS, P.A. 401(K) 2021 411982173 2022-06-29 RELF EYECARE SPECIALISTS, P.A. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIR BASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2022-06-29
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-29
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
RELF EYECARE SPECIALISTS, P.A. 401(K) 2020 411982173 2021-10-01 RELF EYECARE SPECIALISTS, P.A. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIR BASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2021-10-01
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
RELF EYECARE SPECIALISTS, P.A. 401(K) 2019 411982173 2020-09-22 RELF EYECARE SPECIALISTS, P.A. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIR BASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2020-09-22
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-22
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
RELF EYECARE SPECIALISTS, P.A. 401(K) PROFIT SHARING PLAN 2018 411982173 2019-10-09 RELF EYECARE SPECIALISTS, P.A. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIRBASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-09
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
RELF EYECARE SPECIALISTS, P.A. 401(K) PROFIT SHARING PLAN 2017 411982173 2018-10-15 RELF EYECARE SPECIALISTS, P.A. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIRBASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-15
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
RELF EYECARE SPECIALISTS, P.A. 401(K) PROFIT SHARING PLAN 2016 411982173 2018-12-17 RELF EYECARE SPECIALISTS, P.A. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIRBASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2018-12-17
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-12-17
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
RELF EYECARE SPECIALISTS, P.A. 401(K) PROFIT SHARING PLAN 2016 411982173 2017-10-09 RELF EYECARE SPECIALISTS, P.A. 30
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIRBASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2017-10-09
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-09
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
RELF EYECARE SPECIALISTS, P.A. 401(K) PROFIT SHARING PLAN 2015 411982173 2016-06-20 RELF EYECARE SPECIALISTS, P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-02-01
Business code 621111
Sponsor’s telephone number 2187203553
Plan sponsor’s address 4413 AIRBASE ROAD, HERMANTOWN, MN, 55811

Signature of
Role Plan administrator
Date 2016-06-20
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-20
Name of individual signing JODI NELSON
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Lisa S Graham Chief Executive Officer 4413 AIR BASE RD, HERMANTOWN, MN 55811–1847, USA

Filing

Filing Name Filing date
Registered Office and/or Agent - Business Corporation (Domestic) 2022-05-25
Annual Reinstatement - Business Corporation (Domestic) 2020-04-16
Administrative Dissolution - Business Corporation (Domestic) 2020-02-20
Business Corporation (Domestic) Business Name (Business Name: Relf Eyecare Specialists, P.A.) 2010-10-27
Original Filing - Business Corporation (Domestic) 2000-08-10
Business Corporation (Domestic) Business Name (Business Name: Relf Eye Associates, P.A.) 2000-08-10

Related by officers

No related officers

Related by address

4413 AIR BASE RD, HERMANTOWN, MN 55811–1847, USA

Relf Eye, LLC

Date of last update: 26 Sep 2024

Sources: Minnesota's Official State Website

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