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Amundson Peterson, Inc.

Company Details

Name: Amundson Peterson, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 13 Aug 2008 (16 years ago)
Company Number: 230cba5a-92d4-e011-a886-001ec94ffe7f
File Number: 2968917-2
Registered Office Address: 110 2nd Str NE, Elbow Lake, MN 56531, USA
Principal Executive Office Address: 110 SECOND STREET NE, PO BOX 973, ELBOW LAKE, MN 56531, USA
ZIP code: 56531
County: Grant County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
API LIFE INSURANCE PLAN 2015 263319840 2016-08-01 AMUNDSON PETERSON INC 118
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2012-01-01
Business code 441228
Sponsor’s telephone number 2186854438
Plan sponsor’s mailing address PO BOX 973, ELBOW LAKE, MN, 565310973
Plan sponsor’s address 110 2ND STREET, ELBOW LAKE, MN, 56531

Number of participants as of the end of the plan year

Active participants 111
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2016-08-01
Name of individual signing TERRY AMUNDSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-01
Name of individual signing TERRY AMUNDSON
Valid signature Filed with authorized/valid electronic signature
API SHORT TERM DISABILITY PLAN 2015 263319840 2016-09-12 AMUNDSON PETERSON INC 113
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2014-01-01
Business code 441228
Sponsor’s telephone number 2186854438
Plan sponsor’s mailing address PO BOX 973, ELBOW LAKE, MN, 565310973
Plan sponsor’s address 110 2ND STREET, ELBOW LAKE, MN, 56531

Number of participants as of the end of the plan year

Active participants 106
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2016-09-12
Name of individual signing TERRY AMUNDSON
Valid signature Filed with authorized/valid electronic signature
API MEDICAL PLAN 2014 263319840 2015-07-31 AMUNDSON PETERSON INC 101
Three-digit plan number (PN) 501
Effective date of plan 2012-01-01
Business code 441228
Sponsor’s telephone number 2186854438
Plan sponsor’s mailing address PO BOX 973, ELBOW LAKE, MN, 565310973
Plan sponsor’s address 110 2ND STREET NE, ELBOW LAKE, MN, 56531

Number of participants as of the end of the plan year

Active participants 98
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2015-07-31
Name of individual signing TERRY AMUNDSON
Valid signature Filed with authorized/valid electronic signature
API LIFE INSURANCE PLAN 2014 263319840 2015-07-31 AMUNDSON PETERSON INC 120
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2012-01-01
Business code 441228
Sponsor’s telephone number 2186854438
Plan sponsor’s mailing address PO BOX 973, ELBOW LAKE, MN, 565310973
Plan sponsor’s address 110 2ND STREET NE, ELBOW LAKE, MN, 56531

Number of participants as of the end of the plan year

Active participants 120
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2015-07-31
Name of individual signing TERRY AMUNDSON
Valid signature Filed with authorized/valid electronic signature
API SHORT TERM DISABILITY PLAN 2014 263319840 2015-07-31 AMUNDSON PETERSON INC 115
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2014-01-01
Business code 441228
Sponsor’s telephone number 2186854438
Plan sponsor’s mailing address PO BOX 973, ELBOW LAKE, MN, 565310973
Plan sponsor’s address 110 2ND STREET NE, ELBOW LAKE, MN, 56531

Number of participants as of the end of the plan year

Active participants 114
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of

Role Plan administrator
Date 2015-07-31
Name of individual signing TERRY AMUNDSON
Valid signature Filed with authorized/valid electronic signature
AMUNDSON-PETERSON INC. 401(K) PROFIT SHARING PLAN 2014 263319840 2015-03-20 AMUNDSON-PETERSON INC. 107
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-01-31
Business code 423800
Sponsor’s telephone number 2186854438
Plan sponsor’s address 110 2ND STREET, PO BOX 973, ELBOW LAKE, MN, 565310973

Plan administrator’s name and address

Administrator’s EIN 263319840
Plan administrator’s name AMUNDSON-PETERSON INC.
Plan administrator’s address 110 2ND STREET, PO BOX 973, ELBOW LAKE, MN, 565310973
Administrator’s telephone number 2186854438

Signature of

Role Plan administrator
Date 2015-03-20
Name of individual signing RYAN AMUNDSON
Valid signature Filed with authorized/valid electronic signature
AMUNDSON-PETERSON INC. 401(K) PROFIT SHARING PLAN 2013 263319840 2014-04-16 AMUNDSON-PETERSON INC. 93
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-01-31
Business code 423800
Sponsor’s telephone number 2186854438
Plan sponsor’s address 110 2ND STREET, PO BOX 973, ELBOW LAKE, MN, 565310973

Plan administrator’s name and address

Administrator’s EIN 263319840
Plan administrator’s name AMUNDSON-PETERSON INC.
Plan administrator’s address 110 2ND STREET, PO BOX 973, ELBOW LAKE, MN, 565310973
Administrator’s telephone number 2186854438

Signature of

Role Plan administrator
Date 2014-04-16
Name of individual signing RYAN AMUNDSON
Valid signature Filed with authorized/valid electronic signature
AMUNDSON-PETERSON INC. 401(K) PROFIT SHARING PLAN 2012 263319840 2013-05-28 AMUNDSON-PETERSON INC. 93
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-01-31
Business code 423800
Sponsor’s telephone number 2186854438
Plan sponsor’s address 110 2ND STREET, PO BOX 973, ELBOW LAKE, MN, 565310973

Plan administrator’s name and address

Administrator’s EIN 263319840
Plan administrator’s name AMUNDSON-PETERSON INC.
Plan administrator’s address 110 2ND STREET, PO BOX 973, ELBOW LAKE, MN, 565310973
Administrator’s telephone number 2186854438

Signature of

Role Plan administrator
Date 2013-05-28
Name of individual signing RYAN AMUNDSON
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
ERIC PETERSON Chief Executive Officer PO BOX 973, ELBOW LAKE, MN 56531, USA

Filing

Filing Name Filing date
Administrative Dissolution - Business Corporation (Domestic) 2020-02-20
Merger - Business Corporation (Domestic) 2008-09-30
Original Filing - Business Corporation (Domestic) 2008-08-13
Business Corporation (Domestic) Business Name (Business Name: Amundson Peterson, Inc.) 2008-08-13

Date of last update: 24 Sep 2024

Sources: Minnesota's Official State Website