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  5. Mary T., Inc.

Mary T., Inc.

Company Details

Name: Mary T., Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 21 Feb 1985 (40 years ago)
Company Number: 6deb0355-a8d4-e011-a886-001ec94ffe7f
File Number: 4W-224
Registered Office Address: 1555 118th Ln NW, Coon Rapids, MN 55448, USA
Principal Executive Office Address: 11800 XEON BLVD NW, MINNEAPOLIS, MN 55448–2061, United States
ZIP code: 55448
County: Anoka County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MARY T INC EMPLOYEE BENEFIT PLAN - MEDICAL 2011 411525780 2013-01-31 MARY T INC 122
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2010-07-01
Business code 623000
Sponsor’s telephone number 7638625427
Plan sponsor’s mailing address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Plan sponsor’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448

Plan administrator’s name and address
Administrator’s EIN 411525780
Plan administrator’s name MARY T INC
Plan administrator’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Administrator’s telephone number 7638625427

Number of participants as of the end of the plan year
Active participants 122

Signature of
Role Plan administrator
Date 2013-01-31
Name of individual signing JO GRAVINK
Valid signature Filed with authorized/valid electronic signature
MARY T INC EMPLOYEE BENEFIT PLAN - DENTAL 2011 411525780 2013-01-31 MARY T INC 135
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1997-07-01
Business code 623000
Sponsor’s telephone number 7638625427
Plan sponsor’s mailing address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Plan sponsor’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448

Plan administrator’s name and address
Administrator’s EIN 411525780
Plan administrator’s name MARY T INC
Plan administrator’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Administrator’s telephone number 7638625427

Number of participants as of the end of the plan year
Active participants 135

Signature of
Role Plan administrator
Date 2013-01-31
Name of individual signing JO GRAVINK
Valid signature Filed with authorized/valid electronic signature
MARY T INC EMPLOYEE BENEFIT PLAN - LIFE AND AD&D 2011 411525780 2013-01-31 MARY T INC 310
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1999-09-01
Business code 623000
Sponsor’s telephone number 7638625427
Plan sponsor’s mailing address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Plan sponsor’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448

Plan administrator’s name and address
Administrator’s EIN 411525780
Plan administrator’s name MARY T INC
Plan administrator’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Administrator’s telephone number 7638625427

Number of participants as of the end of the plan year
Active participants 310
Retired or separated participants receiving benefits 0

Signature of
Role Plan administrator
Date 2013-01-31
Name of individual signing JO GRAVINK
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN-DENTAL 2010 411525780 2012-01-25 MARY T INC 133
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1997-07-01
Business code 623000
Sponsor’s telephone number 7638625427
Plan sponsor’s mailing address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Plan sponsor’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448

Plan administrator’s name and address
Administrator’s EIN 411525780
Plan administrator’s name MARY T INC
Plan administrator’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Administrator’s telephone number 7638625427

Number of participants as of the end of the plan year
Active participants 133

Signature of
Role Plan administrator
Date 2012-01-25
Name of individual signing JO GRAVINK
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN-MEDICAL 2010 411525780 2012-01-25 MARY T INC 134
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2010-07-01
Business code 623000
Sponsor’s telephone number 7638625427
Plan sponsor’s mailing address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Plan sponsor’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448

Plan administrator’s name and address
Administrator’s EIN 411525780
Plan administrator’s name MARY T INC
Plan administrator’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Administrator’s telephone number 7638625427

Number of participants as of the end of the plan year
Active participants 134

Signature of
Role Plan administrator
Date 2012-01-25
Name of individual signing JO GRAVINK
Valid signature Filed with authorized/valid electronic signature
MARY T INC EMPLOYEE BENEFIT PLAN - LIFE AND AD&D 2010 411525780 2012-01-25 MARY T INC 308
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1999-09-01
Business code 623000
Sponsor’s telephone number 7638625427
Plan sponsor’s mailing address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Plan sponsor’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448

Plan administrator’s name and address
Administrator’s EIN 411525780
Plan administrator’s name MARY T INC
Plan administrator’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Administrator’s telephone number 7638625427

Number of participants as of the end of the plan year
Active participants 308
Retired or separated participants receiving benefits 0
Number of participants with account balances as of the end of the plan year 0
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 2012-01-25
Name of individual signing JO GRAVINK
Valid signature Filed with authorized/valid electronic signature
MARY T INC EMPLOYEE BENEFIT PLAN - LIFE AND AD&D 2010 411525780 2012-01-25 MARY T INC 308
Three-digit plan number (PN) 504
Effective date of plan 1999-09-01
Business code 623000
Sponsor’s telephone number 7638625427
Plan sponsor’s mailing address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Plan sponsor’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448

Plan administrator’s name and address
Administrator’s EIN 411525780
Plan administrator’s name MARY T INC
Plan administrator’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Administrator’s telephone number 7638625427

Number of participants as of the end of the plan year
Active participants 308
Retired or separated participants receiving benefits 0
Number of participants with account balances as of the end of the plan year 0
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 2012-01-25
Name of individual signing JO GRAVINK
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN-MEDICAL 2010 411525780 2012-01-25 MARY T INC 134
Three-digit plan number (PN) 501
Effective date of plan 2010-07-01
Business code 623000
Sponsor’s telephone number 7638625427
Plan sponsor’s mailing address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Plan sponsor’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448

Plan administrator’s name and address
Administrator’s EIN 411525780
Plan administrator’s name MARY T INC
Plan administrator’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Administrator’s telephone number 7638625427

Number of participants as of the end of the plan year
Active participants 134

Signature of
Role Plan administrator
Date 2012-01-25
Name of individual signing JO GRAVINK
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN-DENTAL 2010 411525780 2012-01-25 MARY T INC 133
Three-digit plan number (PN) 502
Effective date of plan 1997-07-01
Business code 623000
Sponsor’s telephone number 7638625427
Plan sponsor’s mailing address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Plan sponsor’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448

Plan administrator’s name and address
Administrator’s EIN 411525780
Plan administrator’s name MARY T INC
Plan administrator’s address 1555 118TH LANE NW, COON RAPIDS, MN, 55448
Administrator’s telephone number 7638625427

Number of participants as of the end of the plan year
Active participants 133

Signature of
Role Plan administrator
Date 2012-01-25
Name of individual signing JO GRAVINK
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Mary M Tjosvold Chief Executive Officer 11800 XEON BLVD NW, MINNEAPOLIS, MN 55448–2061, United States

Filing

Filing Name Filing date
Registered Office and/or Agent - Business Corporation (Domestic) 1996-05-15
Consent to Use of Name - Business Corporation (Domestic) 1989-01-30
Business Corporation (Domestic) Business Name (Business Name: Mary T., Inc.) 1985-12-27
Original Filing - Business Corporation (Domestic) 1985-02-21
Business Corporation (Domestic) Business Name (Business Name: Camilia Rose Home Health Care, Inc.) 1985-02-21

Related by officers

Mary M Tjosvold

Camilia Rose Company, Inc. Camilia Rose Care Center LLC Camilia Rose Parking Lot, LLC CAROLINE CORPORATION Coon Rapids - Brick House, LLC Coon Rapids - Brown House, LLC Coon Rapids - Northdale Land, LLC Coon Rapids - Riverview, LLC Coon Rapids - Uplander, LLC Villas by Mary T. of Palm, LLC

Related by address

1555 118th Ln NW, Coon Rapids, MN 55448, USA

Creekside Cottage Assisted Living Braemar Powell Avocet LLC Coon Rapids - Unity Street LLC Braemar Powell SA LLC MARY MARGARET TJOSVOLD LIMITED PARTNERSHIP Mary T. Maryland, LLC Mary T. Properties, LLC Villas by Mary T on Sand Creek, LLC Mound - Eagle Gardens, LLC DeMAR ASSOCIATES

11800 XEON BLVD NW, MINNEAPOLIS, MN 55448–2061, United States

Camilia Rose Company, Inc. Camilia Rose Care Center LLC Camilia Rose Parking Lot, LLC CAROLINE CORPORATION Coon Rapids - Brick House, LLC Coon Rapids - Brown House, LLC Coon Rapids - Northdale Land, LLC Coon Rapids - Riverview, LLC Coon Rapids - Uplander, LLC Villas by Mary T. of Caroline, LLC

Date of last update: 01 Nov 2024

Sources: Minnesota's Official State Website

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