|
SIMON SYSTEMS, INC. PROFIT SHARING PLAN AND TRUST
|
2011
|
411614598
|
2012-12-17
|
SIMON SYSTEMS, INC.
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1993-01-01
|
| Business code |
541519
|
| Sponsor’s telephone number |
9524489922
|
| Plan sponsor’s
address |
323 LAKE HAZELTINE DR, CHASKA, MN, 55318
|
Plan administrator’s name and address
| Administrator’s EIN |
411614598 |
| Plan administrator’s name |
SIMON SYSTEMS, INC. |
| Plan administrator’s
address |
323 LAKE HAZELTINE DR, CHASKA, MN, 55318 |
| Administrator’s telephone number |
9524489922 |
Signature of
| Role |
Plan administrator |
| Date |
2012-12-17 |
| Name of individual signing |
TRAVIS STENBERG |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SIMON SYSTEMS INC PROFIT SHARING PLAN AND TRUST
|
2010
|
411614598
|
2011-08-15
|
SIMON SYSTEMS INC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1993-01-01
|
| Business code |
541519
|
| Sponsor’s telephone number |
9524489922
|
| Plan sponsor’s mailing address |
323 LAKE HAZELTINE DR, CHASKA, MN, 553181033
|
| Plan sponsor’s
address |
323 LAKE HAZELTINE DR, CHASKA, MN, 553181033
|
Plan administrator’s name and address
| Administrator’s EIN |
411614598 |
| Plan administrator’s name |
SIMON SYSTEMS INC |
| Plan administrator’s
address |
323 LAKE HAZELTINE DR, CHASKA, MN, 553181033 |
| Administrator’s telephone number |
9524489922 |
Number of participants as of the end of the plan year
| Active participants |
6 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
6 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-08-15 |
| Name of individual signing |
DON CHRISTENSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
SIMON SYSTEMS INC PROFIT SHARING PLAN AND TRUST
|
2009
|
411614598
|
2010-11-01
|
SIMON SYSTEMS INC
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1993-01-01
|
| Business code |
541519
|
| Sponsor’s telephone number |
9524489922
|
| Plan sponsor’s mailing address |
323 LAKE HAZELTINE DR, CHASKA, MN, 553181033
|
| Plan sponsor’s
address |
323 LAKE HAZELTINE DR, CHASKA, MN, 553181033
|
Plan administrator’s name and address
| Administrator’s EIN |
411614598 |
| Plan administrator’s name |
SIMON SYSTEMS INC |
| Plan administrator’s
address |
323 LAKE HAZELTINE DR, CHASKA, MN, 553181033 |
| Administrator’s telephone number |
9524489922 |
Number of participants as of the end of the plan year
| Active participants |
6 |
| Retired or separated participants receiving
benefits |
0 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
| Number of
participants
with
account balances as of the end of the plan year |
6 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-11-01 |
| Name of individual signing |
DON CHRISTENSEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
