LIFETRACK 403(B) PLAN
|
2022
|
410874507
|
2023-03-07
|
LIFETRACK RESOURCES, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
6519692251
|
Plan sponsor’s
address |
709 UNIVERSITY AVE W, ST PAUL, MN, 55104
|
Signature of
Role |
Plan administrator |
Date |
2023-03-07 |
Name of individual signing |
DENISE BAKER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LONG TERM DISABILITY
|
2010
|
410874507
|
2011-08-23
|
LIFETRACK RESOURCES, INC.
|
92
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2010-04-01
|
Business code |
624310
|
Sponsor’s telephone number |
6512652305
|
Plan
sponsor’s DBA name |
NON-PROFIT
|
Plan sponsor’s mailing address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan sponsor’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan administrator’s name and address
Administrator’s EIN |
410874507 |
Plan administrator’s name |
LIFETRACK RESOURCES, INC. |
Plan administrator’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104 |
Administrator’s telephone number |
6512652305 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-08-23 |
Name of individual signing |
KIM WAGNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LONG TERM DISABILITY
|
2010
|
410874507
|
2011-08-23
|
LIFETRACK RESOURCES, INC.
|
92
|
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2010-04-01
|
Business code |
624310
|
Sponsor’s telephone number |
6512652305
|
Plan
sponsor’s DBA name |
NON-PROFIT
|
Plan sponsor’s mailing address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan sponsor’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan administrator’s name and address
Administrator’s EIN |
410874507 |
Plan administrator’s name |
LIFETRACK RESOURCES, INC. |
Plan administrator’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104 |
Administrator’s telephone number |
6512652305 |
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2011-08-23 |
Name of individual signing |
KIM WAGNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2010
|
410874507
|
2011-08-23
|
LIFETRACK RESOURCES, INC.
|
70
|
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-04-01
|
Business code |
624310
|
Sponsor’s telephone number |
6512652305
|
Plan sponsor’s mailing address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan sponsor’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan administrator’s name and address
Administrator’s EIN |
410874507 |
Plan administrator’s name |
LIFETRACK RESOURCES, INC. |
Plan administrator’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104 |
Administrator’s telephone number |
6512652305 |
Number of participants as of the end of the plan year
Active participants |
72 |
Retired or separated participants receiving
benefits |
4 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-08-23 |
Name of individual signing |
KIM WAGNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2010
|
410874507
|
2011-08-23
|
LIFETRACK RESOURCES, INC.
|
70
|
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-04-01
|
Business code |
624310
|
Sponsor’s telephone number |
6512652305
|
Plan sponsor’s mailing address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan sponsor’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan administrator’s name and address
Administrator’s EIN |
410874507 |
Plan administrator’s name |
LIFETRACK RESOURCES, INC. |
Plan administrator’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104 |
Administrator’s telephone number |
6512652305 |
Number of participants as of the end of the plan year
Active participants |
72 |
Retired or separated participants receiving
benefits |
4 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-08-23 |
Name of individual signing |
KIM WAGNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2010
|
410874507
|
2011-08-23
|
LIFETRACK RESOURCES, INC.
|
70
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-04-01
|
Business code |
624310
|
Sponsor’s telephone number |
6512652305
|
Plan sponsor’s mailing address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan sponsor’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan administrator’s name and address
Administrator’s EIN |
410874507 |
Plan administrator’s name |
LIFETRACK RESOURCES, INC. |
Plan administrator’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104 |
Administrator’s telephone number |
6512652305 |
Number of participants as of the end of the plan year
Active participants |
72 |
Retired or separated participants receiving
benefits |
4 |
Signature of
Role |
Plan administrator |
Date |
2011-08-23 |
Name of individual signing |
KIM WAGNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BASIC LIFE
|
2010
|
410874507
|
2011-08-23
|
LIFETRACK RESOURCES, INC.
|
94
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2010-04-01
|
Business code |
624310
|
Sponsor’s telephone number |
6512652305
|
Plan
sponsor’s DBA name |
NON-PROFIT
|
Plan sponsor’s mailing address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan sponsor’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan administrator’s name and address
Administrator’s EIN |
231503749 |
Plan administrator’s name |
LIFETRACK RESOURCES, INC. |
Plan administrator’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104 |
Administrator’s telephone number |
6512652305 |
Number of participants as of the end of the plan year
Active participants |
94 |
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 |
0 |
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 |
2011-08-23 |
Name of individual signing |
KIM WAGNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BASIC LIFE
|
2010
|
410874507
|
2011-07-26
|
LIFETRACK RESOURCES, INC.
|
94
|
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2010-04-01
|
Business code |
624310
|
Sponsor’s telephone number |
6512652305
|
Plan
sponsor’s DBA name |
NON-PROFIT
|
Plan sponsor’s mailing address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan sponsor’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan administrator’s name and address
Administrator’s EIN |
231503749 |
Plan administrator’s name |
LIFETRACK RESOURCES, INC. |
Plan administrator’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104 |
Administrator’s telephone number |
6512652305 |
Number of participants as of the end of the plan year
Active participants |
94 |
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 |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-07-26 |
Name of individual signing |
KIM WAGNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LONG TERM DISABILITY
|
2010
|
410874507
|
2011-07-26
|
LIFETRACK RESOURCES, INC.
|
92
|
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2010-04-01
|
Business code |
624310
|
Sponsor’s telephone number |
6512652305
|
Plan
sponsor’s DBA name |
NON-PROFIT
|
Plan sponsor’s mailing address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan sponsor’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan administrator’s name and address
Administrator’s EIN |
410874507 |
Plan administrator’s name |
LIFETRACK RESOURCES, INC. |
Plan administrator’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104 |
Administrator’s telephone number |
6512652305 |
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2011-07-26 |
Name of individual signing |
KIM WAGNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LONG TERM DISABILITY
|
2009
|
231503749
|
2010-07-14
|
LIFETRACK RESOURCES, INC.
|
111
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2009-04-01
|
Business code |
624310
|
Sponsor’s telephone number |
6512652305
|
Plan sponsor’s mailing address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan sponsor’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104
|
Plan administrator’s name and address
Administrator’s EIN |
231503749 |
Plan administrator’s name |
LIFETRACK RESOURCES, INC. |
Plan administrator’s
address |
709 UNIVERSITY AVE. WEST, ST. PAUL, MN, 55104 |
Administrator’s telephone number |
6512652305 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-07-14 |
Name of individual signing |
KIM WAGNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|