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  5. INDEPENDENT LIFESTYLES, INC.

INDEPENDENT LIFESTYLES, INC.

Company Details

Name: INDEPENDENT LIFESTYLES, INC.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 18 Aug 1987 (37 years ago)
Company Number: 4a9b2e25-bad4-e011-a886-001ec94ffe7f
File Number: 5R-114
Registered Office Address: 5001 Chowen Ave S, Mpls, MN 55410, USA
ZIP code: 55410
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
INDEPENDENT LIFESTYLES, INC 403(B) PLAN 2019 411871141 2020-10-01 INDEPENDENT LIFESTYLES, INC. 86
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 3205299000
Plan sponsor’s address 215 N BENTON DR, SAUK RAPIDS, MN, 563791530

Signature of
Role Plan administrator
Date 2020-10-01
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
INDEPENDENT LIFESTYLES, INC 403(B) PLAN 2018 411871141 2019-10-10 INDEPENDENT LIFESTYLES, INC. 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 3205299000
Plan sponsor’s address 215 N BENTON DR, SAUK RAPIDS, MN, 563791530

Signature of
Role Plan administrator
Date 2019-10-10
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
INDEPENDENT LIFESTYLES, INC 403(B) PLAN 2017 411871141 2018-10-15 INDEPENDENT LIFESTYLES, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 3205299000
Plan sponsor’s address 215 N BENTON DR, SAUK RAPIDS, MN, 563791530

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
INDEPENDENT LIFESTYLES, INC 403(B) PLAN 2016 411871141 2017-07-25 INDEPENDENT LIFESTYLES, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 3205299000
Plan sponsor’s mailing address 215 N BENTON DR, SAUK RAPIDS, MN, 563791530
Plan sponsor’s address 215 N BENTON DR, SAUK RAPIDS, MN, 563791530

Number of participants as of the end of the plan year
Active participants 19
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Number of participants with account balances as of the end of the plan year 21
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 2017-07-25
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-25
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
INDEPENDENT LIFESTYLES, INC 403(B) PLAN 2015 411871141 2016-07-20 INDEPENDENT LIFESTYLES, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 3205299000
Plan sponsor’s mailing address 215 N BENTON DR, SAUK RAPIDS, MN, 563791530
Plan sponsor’s address 215 N BENTON DR, SAUK RAPIDS, MN, 563791530

Number of participants as of the end of the plan year
Active participants 17
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Number of participants with account balances as of the end of the plan year 19
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 2016-07-20
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
INDEPENDENT LIFESTYLES, INC 403(B) PLAN 2014 411871141 2016-01-04 INDEPENDENT LIFESTYLES, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 3205299000
Plan sponsor’s mailing address 215 NORTH BENTON DRIVE, SAUK RAPIDS, MN, 56379
Plan sponsor’s address 215 NORTH BENTON DRIVE, SAUK RAPIDS, MN, 56379

Number of participants as of the end of the plan year
Active participants 16
Retired or separated participants receiving benefits 0
Number of participants with account balances as of the end of the plan year 19
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 2016-01-04
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-01-04
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
INDEPENDENT LIFESTYLES, INC 403(B) PLAN 2013 411871141 2014-06-09 INDEPENDENT LIFESTYLES, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 3205299000
Plan sponsor’s mailing address 215 NORTH BENTON DRIVE, SAUK RAPIDS, MN, 56379
Plan sponsor’s address 215 NORTH BENTON DRIVE, SAUK RAPIDS, MN, 56379

Number of participants as of the end of the plan year
Active participants 10
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 13
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 2014-06-05
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
INDEPENDENT LIFESTYLES, INC 403(B) PLAN 2012 411871141 2014-06-09 INDEPENDENT LIFESTYLES, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 3205299000
Plan sponsor’s mailing address 215 NORTH BENTON DRIVE, SAUK RAPIDS, MN, 56379
Plan sponsor’s address 215 NORTH BENTON DRIVE, SAUK RAPIDS, MN, 56379

Number of participants as of the end of the plan year
Active participants 9
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 13
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 2014-06-05
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature
INDEPENDENT LIFESTYLES, INC 403(B) PLAN 2011 411871141 2012-05-03 INDEPENDENT LIFESTYLES, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 3205299000
Plan sponsor’s mailing address 215 NORTH BENTON DRIVE, SAUK RAPIDS, MN, 56379
Plan sponsor’s address 215 NORTH BENTON DRIVE, SAUK RAPIDS, MN, 56379

Plan administrator’s name and address
Administrator’s EIN 411871141
Plan administrator’s name INDEPENDENT LIFESTYLES, INC.
Plan administrator’s address 215 NORTH BENTON DRIVE, SAUK RAPIDS, MN, 56379
Administrator’s telephone number 3205299000

Number of participants as of the end of the plan year
Active participants 8
Number of participants with account balances as of the end of the plan year 13

Signature of
Role Plan administrator
Date 2012-05-03
Name of individual signing TERRY JOHNSON
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Michael R Wiley Chief Executive Officer 5001 Chowen Ave S, Mpls, MN 55410, USA

Filing

Filing Name Filing date
Administrative Dissolution - Business Corporation (Domestic) 1992-12-31
Original Filing - Business Corporation (Domestic) 1987-08-18
Business Corporation (Domestic) Business Name (Business Name: INDEPENDENT LIFESTYLES, INC.) 1987-08-18

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Michael R Wiley

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Date of last update: 27 Dec 2024

Sources: Minnesota's Official State Website

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