NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2023
|
410954325
|
2024-10-15
|
NORTHFIELD CARE CENTER, INC.
|
121
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643474
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Plan sponsor’s
address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Number of participants as of the end of the plan year
Active participants |
27 |
Retired or separated participants receiving
benefits |
93 |
Number of
participants
with
account balances as of the end of the plan year |
120 |
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 |
2024-10-15 |
Name of individual signing |
TOM NIELSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-10-15 |
Name of individual signing |
TOM NIELSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2022
|
410954325
|
2023-12-08
|
NORTHFIELD CARE CENTER, INC.
|
120
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643474
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Plan sponsor’s
address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Number of participants as of the end of the plan year
Active participants |
27 |
Retired or separated participants receiving
benefits |
94 |
Number of
participants
with
account balances as of the end of the plan year |
121 |
Signature of
Role |
Plan administrator |
Date |
2023-12-07 |
Name of individual signing |
TOM NIELSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2021
|
410954325
|
2022-10-17
|
NORTHFIELD CARE CENTER, INC
|
121
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643474
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Plan sponsor’s
address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Number of participants as of the end of the plan year
Active participants |
104 |
Retired or separated participants receiving
benefits |
1 |
Other
retired or separated participants entitled to future benefits |
15 |
Number of
participants
with
account balances as of the end of the plan year |
120 |
Signature of
Role |
Plan administrator |
Date |
2022-10-17 |
Name of individual signing |
TOM NIELSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-10-17 |
Name of individual signing |
TOM NIELSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2020
|
410954325
|
2021-10-12
|
NORTHFIELD CARE CENTER, INC.
|
120
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643465
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Plan sponsor’s
address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Number of participants as of the end of the plan year
Active participants |
32 |
Retired or separated participants receiving
benefits |
89 |
Number of
participants
with
account balances as of the end of the plan year |
121 |
Signature of
Role |
Plan administrator |
Date |
2021-10-12 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2019
|
410954325
|
2020-10-14
|
NORTHFIELD CARE CENTER, INC.
|
121
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643465
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Plan sponsor’s
address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Number of participants as of the end of the plan year
Active participants |
37 |
Retired or separated participants receiving
benefits |
83 |
Number of
participants
with
account balances as of the end of the plan year |
120 |
Signature of
Role |
Plan administrator |
Date |
2020-10-14 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-10-14 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2018
|
410954325
|
2019-10-11
|
NORTHFIELD CARE CENTER, INC.
|
118
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643465
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Plan sponsor’s
address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Number of participants as of the end of the plan year
Active participants |
38 |
Retired or separated participants receiving
benefits |
83 |
Signature of
Role |
Plan administrator |
Date |
2019-10-11 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2017
|
410954325
|
2018-10-10
|
NORTHFIELD CARE CENTER, INC.
|
118
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643465
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Plan sponsor’s
address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Number of participants as of the end of the plan year
Active participants |
34 |
Retired or separated participants receiving
benefits |
84 |
Number of
participants
with
account balances as of the end of the plan year |
118 |
Signature of
Role |
Plan administrator |
Date |
2018-10-10 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-10-10 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2016
|
410954325
|
2017-10-12
|
NORTHFIELD CARE CENTER, INC.
|
125
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643465
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Plan sponsor’s
address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Number of participants as of the end of the plan year
Active participants |
31 |
Retired or separated participants receiving
benefits |
87 |
Number of
participants
with
account balances as of the end of the plan year |
118 |
Signature of
Role |
Plan administrator |
Date |
2017-10-12 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-10-12 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2015
|
410954325
|
2016-10-04
|
NORTHFIELD CARE CENTER, INC.
|
134
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643465
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Plan sponsor’s
address |
900 CANNON VALLEY DR, NORTHFIELD, MN, 550571334
|
Number of participants as of the end of the plan year
Active participants |
34 |
Retired or separated participants receiving
benefits |
91 |
Number of
participants
with
account balances as of the end of the plan year |
125 |
Signature of
Role |
Plan administrator |
Date |
2016-10-04 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-10-04 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHFIELD CARE CENTER INC. RETIREMENT PLAN
|
2014
|
410954325
|
2015-10-12
|
NORTHFIELD CARE CENTER, INC.
|
137
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1982-12-01
|
Business code |
623000
|
Sponsor’s telephone number |
5076643465
|
Plan sponsor’s mailing address |
900 CANNON VALLEY DRIVE, NORTHFIELD, MN, 55057
|
Plan sponsor’s
address |
900 CANNON VALLEY DRIVE, NORTHFIELD, MN, 55057
|
Number of participants as of the end of the plan year
Active participants |
38 |
Retired or separated participants receiving
benefits |
96 |
Number of
participants
with
account balances as of the end of the plan year |
134 |
Signature of
Role |
Plan administrator |
Date |
2015-10-12 |
Name of individual signing |
SCOTT BLUM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|