|
FANTASTIC SAMS ROGERS 401(K) PLAN
|
2012
|
204845363
|
2013-06-21
|
FANTASTIC SAMS ROGERS
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
812112
|
| Sponsor’s telephone number |
7634281183
|
| Plan sponsor’s
address |
13690 ROGERS DRIVE, ROGERS, MN, 55374
|
Signature of
| Role |
Plan administrator |
| Date |
2013-06-21 |
| Name of individual signing |
JOHN RAUENHORST |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2013-06-21 |
| Name of individual signing |
JOHN RAUENHORST |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FANTASTIC SAMS ROGERS 401(K) PLAN
|
2011
|
204845363
|
2012-06-12
|
FANTASTIC SAMS ROGERS
|
15
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
812112
|
| Sponsor’s telephone number |
7634281183
|
| Plan sponsor’s
address |
13690 ROGERS DRIVE, ROGERS, MN, 55374
|
Plan administrator’s name and address
| Administrator’s EIN |
204845363 |
| Plan administrator’s name |
FANTASTIC SAMS ROGERS |
| Plan administrator’s
address |
13690 ROGERS DRIVE, ROGERS, MN, 55374 |
| Administrator’s telephone number |
7634281183 |
Signature of
| Role |
Plan administrator |
| Date |
2012-06-12 |
| Name of individual signing |
JOHN RAUENHORST |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2012-06-12 |
| Name of individual signing |
JOHN RAUENHORST |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FANTASTIC SAMS ROGERS 401(K) PLAN
|
2010
|
204845363
|
2011-08-08
|
FANTASTIC SAMS ROGERS
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
812112
|
| Sponsor’s telephone number |
7634281183
|
| Plan sponsor’s
address |
13690 ROGERS DRIVE, ROGERS, MN, 55374
|
Plan administrator’s name and address
| Administrator’s EIN |
204845363 |
| Plan administrator’s name |
FANTASTIC SAMS ROGERS |
| Plan administrator’s
address |
13690 ROGERS DRIVE, ROGERS, MN, 55374 |
| Administrator’s telephone number |
7634281183 |
Signature of
| Role |
Plan administrator |
| Date |
2011-08-08 |
| Name of individual signing |
JOHN RAUENHORST |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-08-08 |
| Name of individual signing |
JOHN RAUENHORST |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FANTASTIC SAMS ROGERS 401(K) PLAN
|
2009
|
204845363
|
2010-07-12
|
FANTASTIC SAMS ROGERS
|
7
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2008-01-01
|
| Business code |
812112
|
| Sponsor’s telephone number |
7634281183
|
| Plan sponsor’s
address |
13690 ROGERS DRIVE, ROGERS, MN, 55374
|
Plan administrator’s name and address
| Administrator’s EIN |
204845363 |
| Plan administrator’s name |
FANTASTIC SAMS ROGERS |
| Plan administrator’s
address |
13690 ROGERS DRIVE, ROGERS, MN, 55374 |
| Administrator’s telephone number |
7634281183 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-11 |
| Name of individual signing |
JOHN E RAUENHORST |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-07-11 |
| Name of individual signing |
JOHN E RAUENHORST |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
