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  5. Amphora Medical, Inc.

Amphora Medical, Inc.

Company Details

Name: Amphora Medical, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Foreign)
Status: Inactive
Date formed: 12 Apr 2013 (12 years ago)
Company Number: 3d1a30a9-d2a5-e211-82ac-001ec94ffe7f
File Number: 667100100025
Registered Office Address: 6901 E Fish Lk Rd #106, Maple Grove, MN 55369, USA
ZIP code: 55369
County: Hennepin County
Place of Formation: Delaware

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AMPHORA MEDICAL, INC. 401(K) PLAN 2019 454112773 2020-04-08 AMPHORA MEDICAL, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 339110
Sponsor’s telephone number 7632203730
Plan sponsor’s address 4012 VINCENT AVE S, MINNEAPOLIS, MN, 554101138

Signature of
Role Plan administrator
Date 2020-04-08
Name of individual signing LEOTA PEARSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-04-08
Name of individual signing LEOTA PEARSON
Valid signature Filed with authorized/valid electronic signature
AMPHORA MEDICAL, INC. 401(K) PLAN 2018 454112773 2019-04-24 AMPHORA MEDICAL, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 339110
Sponsor’s telephone number 7632203730
Plan sponsor’s address 6901 E FISH LAKE RD STE 106, MAPLE GROVE, MN, 553695454

Signature of
Role Plan administrator
Date 2019-04-24
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-04-24
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature
AMPHORA MEDICAL, INC. 401(K) PLAN 2017 454112773 2018-03-07 AMPHORA MEDICAL, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 339110
Sponsor’s telephone number 7632203730
Plan sponsor’s address 6901 E FISH LAKE RD STE 106, MAPLE GROVE, MN, 553695454

Signature of
Role Plan administrator
Date 2018-03-07
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-03-07
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature
AMPHORA MEDICAL, INC. 401(K) PLAN 2016 454112773 2017-07-06 AMPHORA MEDICAL, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 339110
Sponsor’s telephone number 7632203730
Plan sponsor’s address 6901 E FISH LAKE RD STE 106, MAPLE GROVE, MN, 553695454

Signature of
Role Plan administrator
Date 2017-07-06
Name of individual signing TOM RESSEMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-06
Name of individual signing TOM RESSEMANN
Valid signature Filed with authorized/valid electronic signature
AMPHORA MEDICAL, INC. 401(K) PLAN 2015 454112773 2016-04-20 AMPHORA MEDICAL, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 339110
Sponsor’s telephone number 7632203730
Plan sponsor’s address 6901 E FISH LAKE RD STE 106, MAPLE GROVE, MN, 553695454

Signature of
Role Plan administrator
Date 2016-04-20
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-04-20
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature
AMPHORA MEDICAL, INC. 401(K) PLAN 2014 454112773 2015-03-25 AMPHORA MEDICAL, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 339110
Sponsor’s telephone number 7632203730
Plan sponsor’s address 6901 E FISH LAKE RD STE 106, MAPLE GROVE, MN, 553695454

Signature of
Role Plan administrator
Date 2015-03-25
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-03-25
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature
AMPHORA MEDICAL, INC. 401(K) PLAN 2013 454112773 2014-07-23 AMPHORA MEDICAL, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 339110
Sponsor’s telephone number 7632203730
Plan sponsor’s address 6901 E FISH LAKE RD STE 106, MAPLE GROVE, MN, 553695454

Signature of
Role Plan administrator
Date 2014-07-23
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-23
Name of individual signing THOMAS RESSEMANN
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Tom V. Ressemann Chief Executive Officer 6901 East Fish Lake Road, Suite 106, Maple Grove, MN 55369, USA

Agent

Name Role
Tom V Ressemann Agent

Filing

Filing Name Filing date
Registered Office and/or Agent - Business Corporation (Foreign) 2016-03-03
Annual Reinstatement - Business Corporation (Foreign) 2015-07-06
Revocation - Business Corporation (Foreign) 2015-06-12
Original Filing - Business Corporation (Foreign) (Business Name: Amphora Medical, Inc.) 2013-04-12

Related by officers

No related officers

Related by address

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Date of last update: 23 Dec 2024

Sources: Minnesota's Official State Website

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