SILVERSTREAK DAIRIES, LLC EMPLOYEE HEALTH CARE PLAN
|
2023
|
208058778
|
2024-07-29
|
SILVERSTREAK DAIRIES LLC
|
76
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
112120
|
Sponsor’s telephone number |
3202742837
|
Plan sponsor’s mailing address |
26939 83RD ST, PIERZ, MN, 563647635
|
Plan sponsor’s
address |
26939 83RD ST, PIERZ, MN, 563647635
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-29 |
Name of individual signing |
STANLEY RIDGEWAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-07-29 |
Name of individual signing |
STANLEY RIDGEWAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SILVERSTREAK DAIRIES, LLC EMPLOYEE HEALTH CARE PL.AN
|
2022
|
208058778
|
2023-06-30
|
SILVERSTREAK DAIRIES, LLC
|
79
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
112120
|
Sponsor’s telephone number |
3202742837
|
Plan sponsor’s mailing address |
26939 83RD ST, PIERZ, MN, 563647635
|
Plan sponsor’s
address |
26939 83RD ST, PIERZ, MN, 563647635
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-06-30 |
Name of individual signing |
STANLEY RIDGEWAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-06-30 |
Name of individual signing |
STANLEY RIDGEWAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SILVERSTREAK DAIRIES, LLC EMPLOYEE HEALTH CARE PLAN
|
2021
|
208058778
|
2022-06-30
|
SILVERSTREAK DAIRIES, LLC
|
84
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
112120
|
Sponsor’s telephone number |
3202742837
|
Plan sponsor’s mailing address |
26939 83RD ST, PIERZ, MN, 563647635
|
Plan sponsor’s
address |
26939 83RD ST, PIERZ, MN, 563647635
|
Plan administrator’s name and address
Administrator’s EIN |
208058778 |
Plan administrator’s name |
SILVERSTREAK DAIRIES, LLC |
Plan administrator’s
address |
26939 83RD ST, PIERZ, MN, 563647635 |
Administrator’s telephone number |
3202742837 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-06-30 |
Name of individual signing |
STANLEY RIDGEWAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-06-30 |
Name of individual signing |
STANLEY RIDGEWAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SILVERSTREAK DAIRIES, LLC EMPLOYEE HEALTH CARE PLAN
|
2021
|
208058778
|
2022-06-30
|
SILVERSTREAK DAIRIES, LLC
|
84
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
112120
|
Sponsor’s telephone number |
3202742837
|
Plan sponsor’s mailing address |
26939 83RD ST, PIERZ, MN, 563647635
|
Plan sponsor’s
address |
26939 83RD ST, PIERZ, MN, 563647635
|
Plan administrator’s name and address
Administrator’s EIN |
208058778 |
Plan administrator’s name |
SILVERSTREAK DAIRIES, LLC |
Plan administrator’s
address |
26939 83RD ST, PIERZ, MN, 563647635 |
Administrator’s telephone number |
3202742837 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-06-30 |
Name of individual signing |
STANLEY RIDGEWAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-06-30 |
Name of individual signing |
STANLEY RIDGEWAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SILVERSTREAK DAIRIES, LLC EMPLOYEE HEALTH CARE PLAN
|
2020
|
208058778
|
2021-07-28
|
SILVERSTREAK DAIRIES, LLC
|
84
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
112120
|
Sponsor’s telephone number |
3207615618
|
Plan sponsor’s mailing address |
26939 83RD ST, PIERZ, MN, 563647635
|
Plan sponsor’s
address |
26939 83RD ST, PIERZ, MN, 563647635
|
Number of participants as of the end of the plan year
Active participants |
86 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2021-07-28 |
Name of individual signing |
ANN HAYES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-07-28 |
Name of individual signing |
ANN HAYES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SILVERSTREAK DAIRIES, LLC EMPLOYEE HEALTH CARE PLAN
|
2019
|
208058778
|
2021-07-28
|
SILVERSTREAK DAIRIES, LLC
|
64
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
112120
|
Sponsor’s telephone number |
3207615618
|
Plan sponsor’s mailing address |
26939 83RD ST, PIERZ, MN, 563647635
|
Plan sponsor’s
address |
26939 83RD ST, PIERZ, MN, 563647635
|
Number of participants as of the end of the plan year
Active participants |
86 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2021-07-28 |
Name of individual signing |
ANN HAYES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-07-28 |
Name of individual signing |
ANN HAYES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|