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LTC Services, Inc.

Company Details

Name: LTC Services, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 26 Dec 2003 (21 years ago)
Company Number: 161a8586-87d4-e011-a886-001ec94ffe7f
File Number: 733766-2
Registered Office Address: 5200 W 78th St, Blmgtn, MN 55435, USA
Principal Executive Office Address: 5200 W 78TH ST, MINNEAPOLIS, MN 55435–5303, USA
ZIP code: 55435
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LTC SERVICES, INC. 401(K) PLAN 2019 593774877 2020-07-29 LTC SERVICES, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W. 78TH STREET, BLOOMINGTON, MN, 55435

Signature of

Role Plan administrator
Date 2020-07-29
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
LTC SERVICES, INC.401(K) PLAN 2018 593774877 2019-06-27 LTC SERVICES, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435

Signature of

Role Plan administrator
Date 2019-06-27
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-27
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
LTC SERVICES, INC.401(K) PLAN 2017 593774877 2018-06-29 LTC SERVICES, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435

Signature of

Role Plan administrator
Date 2018-06-29
Name of individual signing LARRY K HULSEBUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-29
Name of individual signing LARRY K HULSEBUS
Valid signature Filed with authorized/valid electronic signature
LTC SERVICES, INC.401(K) PLAN 2016 593774877 2017-05-25 LTC SERVICES, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435

Signature of

Role Plan administrator
Date 2017-05-25
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-25
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
LTC SERVICES, INC.401(K) PLAN 2015 593774877 2016-07-13 LTC SERVICES, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435

Signature of

Role Plan administrator
Date 2016-07-13
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-13
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
LTC SERVICES, INC.401(K) PLAN 2014 593774877 2015-07-10 LTC SERVICES, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435

Signature of

Role Plan administrator
Date 2015-07-10
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-10
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
LTC SERVICES, INC.401(K) PLAN 2013 593774877 2014-05-29 LTC SERVICES, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435

Signature of

Role Plan administrator
Date 2014-05-29
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-29
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
LTC SERVICES, INC.401(K) PLAN 2012 593774877 2013-07-12 LTC SERVICES, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435

Signature of

Role Plan administrator
Date 2013-07-12
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-12
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
LTC SERVICES, INC.401(K) PLAN 2011 593774877 2012-07-11 LTC SERVICES, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435

Plan administrator’s name and address

Administrator’s EIN 593774877
Plan administrator’s name LTC SERVICES, INC.
Plan administrator’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435
Administrator’s telephone number 9529416800

Signature of

Role Plan administrator
Date 2012-07-11
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-11
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature
LTC SERVICES, INC.401(K) PLAN 2010 593774877 2011-07-15 LTC SERVICES, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 446190
Sponsor’s telephone number 9529416800
Plan sponsor’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435

Plan administrator’s name and address

Administrator’s EIN 593774877
Plan administrator’s name LTC SERVICES, INC.
Plan administrator’s address 5200 W 78TH STREET, BLOOMINGTON, MN, 55435
Administrator’s telephone number 9529416800

Signature of

Role Plan administrator
Date 2011-07-15
Name of individual signing LARRY HULSEBUS
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Lori Hulsebus Chief Executive Officer 5200 W 78TH ST, MINNEAPOLIS, MN 55435–5303, USA

Filing

Filing Name Filing date
Annual Reinstatement - Business Corporation (Domestic) 2014-11-05
Administrative Dissolution Name Hold Release - Business Corporation (Domestic) 2014-02-25
Administrative Dissolution - Business Corporation (Domestic) 2013-02-25
Registered Office and/or Agent - Business Corporation (Domestic) 2009-08-31
Original Filing - Business Corporation (Domestic) 2003-12-26
Business Corporation (Domestic) Business Name (Business Name: LTC Services, Inc.) 2003-12-26

Date of last update: 23 Dec 2024

Sources: Minnesota's Official State Website