|
401K PLAN OF SAFE HAVEN SHELTER FOR YOUTH
|
2013
|
411804846
|
2014-04-29
|
SAFE HAVEN SHELTER FOR YOUTH
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-03-01
|
| Business code |
624100
|
| Plan sponsor’s
address |
13780 MCKENNA RD NW, SHAKOPEE, MN, 55379
|
Plan administrator’s name and address
| Administrator’s EIN |
411804846 |
| Plan administrator’s name |
KERMIT . MAHLUM |
Signature of
| Role |
Plan administrator |
| Date |
2014-04-29 |
| Name of individual signing |
KERMIT MAHLUM |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
401K PLAN OF SAFE HAVEN SHELTER FOR YOUTH
|
2012
|
411804846
|
2014-04-29
|
SAFE HAVEN SHELTER FOR YOUTH
|
6
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-03-01
|
| Business code |
624100
|
| Sponsor’s telephone number |
9522882688
|
| Plan sponsor’s
address |
13780 MCKENNA RD NW, SHAKOPEE, MN, 55379
|
Plan administrator’s name and address
| Administrator’s EIN |
411804846 |
| Plan administrator’s name |
KERMIT A. MAHLUM |
| Plan administrator’s
address |
13780 MCKENNA RD NW, SHAKOPEE, MN, 55379 |
| Administrator’s telephone number |
6128670780 |
Signature of
| Role |
Plan administrator |
| Date |
2014-04-29 |
| Name of individual signing |
KERMIT MAHLUM |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
401K PLAN OF SAFE HAVEN SHELTER FOR YOUTH
|
2011
|
411804846
|
2012-11-08
|
SAFE HAVEN SHELTER FOR YOUTH
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-03-01
|
| Business code |
624100
|
| Sponsor’s telephone number |
9522882688
|
| Plan sponsor’s
address |
13780 MCKENNA RD NW, SHAKOPEE, MN, 55379
|
Plan administrator’s name and address
| Administrator’s EIN |
411804846 |
| Plan administrator’s name |
KERMIT A. MAHLUM |
| Plan administrator’s
address |
13780 MCKENNA RD NW, SHAKOPEE, MN, 55379 |
| Administrator’s telephone number |
6128670780 |
Signature of
| Role |
Plan administrator |
| Date |
2012-11-08 |
| Name of individual signing |
KERMIT A MAHLUM |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
401K PLAN OF SAFE HAVEN SHELTER FOR YOUTH
|
2010
|
411804846
|
2011-06-20
|
SAFE HAVEN SHELTER FOR YOUTH
|
10
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-03-01
|
| Business code |
624100
|
| Sponsor’s telephone number |
9522882688
|
| Plan sponsor’s
address |
13780 MCKENNA ROAD NW, SHAKOPEE, MN, 55379
|
Plan administrator’s name and address
| Administrator’s EIN |
411804846 |
| Plan administrator’s name |
SAFE HAVEN SHELTER FOR YOUTH |
| Plan administrator’s
address |
13780 MCKENNA ROAD NW, SHAKOPEE, MN, 55379 |
| Administrator’s telephone number |
9522882688 |
Signature of
| Role |
Plan administrator |
| Date |
2011-06-20 |
| Name of individual signing |
KRIS GEROLD |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
EMPLOYEE BENEFIT PLAN OF SAFE HAVEN SHELTER FOR YOUTH
|
2009
|
411804846
|
2010-07-22
|
SAFE HAVEN SHELTER FOR YOUTH
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2001-03-01
|
| Business code |
624100
|
| Sponsor’s telephone number |
9522882688
|
| Plan sponsor’s
address |
13780 MCKENNA RD NW, SHAKOPEE, MN, 55379
|
Plan administrator’s name and address
| Administrator’s EIN |
411804846 |
| Plan administrator’s name |
SAFE HAVEN SHELTER FOR YOUTH |
| Plan administrator’s
address |
13780 MCKENNA RD NW, SHAKOPEE, MN, 55379 |
| Administrator’s telephone number |
9522882688 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-22 |
| Name of individual signing |
TERI FUNK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-07-22 |
| Name of individual signing |
TERI FUNK |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
