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 |
|
|