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  5. Family Practice Medical Center of Willmar, P.A.

Family Practice Medical Center of Willmar, P.A.

Company Details

Name: Family Practice Medical Center of Willmar, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 18 Jun 1984 (41 years ago)
Company Number: 5073a0d4-b4d4-e011-a886-001ec94ffe7f
File Number: 4R-263
Registered Office Address: 502 W 2nd Str, Willmar, MN 56201, USA
Principal Executive Office Address: 502 2nd St SW Suite 1, Willmar, MN 56201, USA
ZIP code: 56201
County: Kandiyohi County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2021 411494832 2022-12-19 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 W. 2ND ST., WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2022-12-19
Name of individual signing ANTHONY AMON
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2019 411494832 2020-07-08 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 W. 2ND ST., WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2020-07-08
Name of individual signing STACEY ZONDERVAN
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2018 411494832 2019-08-13 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 W. 2ND ST., WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2019-08-13
Name of individual signing STACEY ZONDERVAN
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2017 411494832 2018-06-25 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 W. 2ND ST., WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2018-06-25
Name of individual signing STACEY ZONDERVAN
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2015 411494832 2016-05-20 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 WEST 2ND STREET, WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2016-05-20
Name of individual signing STACEY ZONDERVAN
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2013 411494832 2014-06-05 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 W. 2ND ST., WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2014-06-05
Name of individual signing GARY MCDOWELL
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2012 411494832 2013-06-04 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 W. 2ND ST., WILLMAR, MN, 56201

Signature of
Role Plan administrator
Date 2013-06-04
Name of individual signing GARY MCDOWELL
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2011 411494832 2012-06-12 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 W. 2ND ST., WILLMAR, MN, 56201

Plan administrator’s name and address
Administrator’s EIN 411494832
Plan administrator’s name FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A.
Plan administrator’s address 502 W. 2ND ST., WILLMAR, MN, 56201
Administrator’s telephone number 3202357232

Signature of
Role Plan administrator
Date 2012-06-12
Name of individual signing GARY MCDOWELL
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2010 411494832 2011-06-08 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 W. 2ND ST., WILLMAR, MN, 56201

Plan administrator’s name and address
Administrator’s EIN 411494832
Plan administrator’s name FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A.
Plan administrator’s address 502 W. 2ND ST., WILLMAR, MN, 56201
Administrator’s telephone number 3202357232

Signature of
Role Plan administrator
Date 2011-06-08
Name of individual signing GARY MCDOWELL
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 401(K) PLAN 2009 411494832 2010-08-03 FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A. 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 3202357232
Plan sponsor’s address 502 W. 2ND ST., WILLMAR, MN, 56201

Plan administrator’s name and address
Administrator’s EIN 411494832
Plan administrator’s name FAMILY PRACTICE MEDICAL CENTER OF WILLMAR, P.A.
Plan administrator’s address 502 W. 2ND ST., WILLMAR, MN, 56201
Administrator’s telephone number 3202357232

Signature of
Role Plan administrator
Date 2010-08-03
Name of individual signing GARY MCDOWELL
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Anthony Amon Chief Executive Officer 502 2nd St SW Suite 1, Willmar, MN 56201, USA

Filing

Filing Name Filing date
Dissolution - Business Corporation (Domestic) 2022-08-18
Intent to Dissolve - Business Corporation (Domestic) 2022-08-18
Annual Reinstatement - Business Corporation (Domestic) 2019-07-30
Administrative Dissolution - Business Corporation (Domestic) 2019-03-15
Registered Office and/or Agent - Business Corporation (Domestic) 1995-05-31
Original Filing - Business Corporation (Domestic) 1984-06-18
Business Corporation (Domestic) Business Name (Business Name: Family Practice Medical Center of Willmar, P.A.) 1984-06-18

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Date of last update: 25 Sep 2024

Sources: Minnesota's Official State Website

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