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  5. CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES, INC.

CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES, INC.

Company Details

Name: CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES, INC.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 20 Nov 2009 (15 years ago)
Company Number: 4027bada-94d4-e011-a886-001ec94ffe7f
File Number: 3574006-2
Registered Office Address: 901 3rd Str S #204, Stillwater, MN 55082, USA
Principal Executive Office Address: 2626 E 82ND ST STE 390, BLOOMINGTON, MN 55425–1386, USA
ZIP code: 55082
County: Washington County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLC INS & FIN SVS 401(K) PLAN 2023 271321207 2024-05-14 CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 524210
Sponsor’s telephone number 9522531020
Plan sponsor’s address 2626 E 82ND STREET, SUITE 390, BLOOMINGTON, MN, 55425

Signature of
Role Plan administrator
Date 2024-05-14
Name of individual signing CASEY CHARLSON
Valid signature Filed with authorized/valid electronic signature
CLC INS & FIN SVS 401(K) PLAN 2022 271321207 2023-06-15 CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 524210
Sponsor’s telephone number 9522531020
Plan sponsor’s address 2626 E 82ND STREET, SUITE 390, BLOOMINGTON, MN, 55425

Signature of
Role Plan administrator
Date 2023-06-15
Name of individual signing CASEY CHARLSON
Valid signature Filed with authorized/valid electronic signature
CLC INS & FIN SVS 401(K) PLAN 2021 271321207 2022-05-16 CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 524210
Sponsor’s telephone number 9522531020
Plan sponsor’s address 2626 E 82ND STREET, SUITE 390, BLOOMINGTON, MN, 55425

Signature of
Role Plan administrator
Date 2022-05-16
Name of individual signing CASEY CHARLSON
Valid signature Filed with authorized/valid electronic signature
CLC INS & FIN SVS 401(K) PLAN 2020 271321207 2021-08-06 CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 524210
Sponsor’s telephone number 9522531020
Plan sponsor’s address 2626 E 82ND STREET, SUITE 390, BLOOMINGTON, MN, 55425

Signature of
Role Plan administrator
Date 2021-08-06
Name of individual signing CASEY CHARLSON
Valid signature Filed with authorized/valid electronic signature
CLC INS & FIN SVS 401(K) PLAN 2019 271321207 2020-05-29 CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 524210
Sponsor’s telephone number 9522531020
Plan sponsor’s address 2626 E 82ND ST SUITE 390, BLOOMINGTON, MN, 55425

Signature of
Role Plan administrator
Date 2020-05-29
Name of individual signing CASEY CHARLSON
Valid signature Filed with authorized/valid electronic signature
CLC INS & FIN SVS 401(K) PLAN 2018 271321207 2019-05-08 CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 524210
Sponsor’s telephone number 9522531020
Plan sponsor’s address 2626 E 82ND ST SUITE 390, BLOOMINGTON, MN, 55425

Signature of
Role Plan administrator
Date 2019-05-08
Name of individual signing CASEY CHARLSON
Valid signature Filed with authorized/valid electronic signature
CLC INS & FIN SVS 401(K) PLAN 2017 271321207 2018-07-25 CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 524210
Sponsor’s telephone number 9522531020
Plan sponsor’s address 2626 E 82ND ST SUITE 390, BLOOMINGTON, MN, 55425

Signature of
Role Plan administrator
Date 2018-07-25
Name of individual signing CASEY CHARLSON
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
CASEY L. CHARLSON Chief Executive Officer 2626 E 82ND ST STE 390, BLOOMINGTON, MN 55425–1386, USA

Agent

Name Role
Steven M O'Brien Agent

Filing

Filing Name Filing date
Annual Reinstatement - Business Corporation (Domestic) 2021-02-26
Administrative Dissolution - Business Corporation (Domestic) 2021-02-11
Original Filing - Business Corporation (Domestic) (Business Name: CASEY L. CHARLSON INSURANCE AND FINANCIAL SERVICES, INC.) 2009-11-20

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Date of last update: 24 Sep 2024

Sources: Minnesota's Official State Website

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