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  5. Great Plain States Insurance Agency, Inc.

Great Plain States Insurance Agency, Inc.

Company Details

Name: Great Plain States Insurance Agency, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 18 May 1990 (35 years ago)
Company Number: 87ac99d3-a9d4-e011-a886-001ec94ffe7f
File Number: 6R-580
Registered Office Address: 11527 Fetterly Road W, Minnetonka, MN 55305, USA
Principal Executive Office Address: 40 S Elm St, Waconia, MN 55387, USA
ZIP code: 55305
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2019 411670693 2020-12-15 GREAT PLAIN STATES INSURANCE AGENCY 4
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525912758
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address PO BOX 16527, ST LOUIS PARK, MN, 554160527

Signature of
Role Plan administrator
Date 2020-12-15
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-12-15
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2019 411670693 2020-12-16 GREAT PLAIN STATES INSURANCE AGENCY 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525912758
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address PO BOX 16527, ST LOUIS PARK, MN, 554160527

Signature of
Role Plan administrator
Date 2020-12-16
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-12-16
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2018 411670693 2019-09-19 GREAT PLAIN STATES INSURANCE AGENCY 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525938717
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address P.O. BOX 16527, MINNEAPOLIS, MN, 55416

Signature of
Role Plan administrator
Date 2019-09-19
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2017 411670693 2018-10-03 GREAT PLAIN STATES INSURANCE AGENCY 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525938717
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address P.O. BOX 16527, MINNEAPOLIS, MN, 55416

Signature of
Role Plan administrator
Date 2018-10-03
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2016 411670693 2017-08-16 GREAT PLAIN STATES INSURANCE AGENCY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525938717
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address P.O. BOX 16527, MINNEAPOLIS, MN, 55416

Signature of
Role Plan administrator
Date 2017-08-16
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2015 411670693 2016-07-14 GREAT PLAIN STATES INSURANCE AGENCY 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525938717
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address 5851 CEDAR LAKE ROAD, ST. LOUIS PARK, MN, 55416

Signature of
Role Plan administrator
Date 2016-07-14
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2014 411670693 2015-07-23 GREAT PLAIN STATES INSURANCE AGENCY 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525938717
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address 5851 CEDAR LAKE ROAD, ST. LOUIS PARK, MN, 55416

Signature of
Role Plan administrator
Date 2015-07-23
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2013 411670693 2014-09-30 GREAT PLAIN STATES INSURANCE AGENCY 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525938717
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address 5851 CEDAR LAKE ROAD, ST. LOUIS PARK, MN, 55416

Signature of
Role Plan administrator
Date 2014-09-30
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2012 411670693 2013-07-01 GREAT PLAIN STATES INSURANCE AGENCY 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525938717
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address 5851 CEDAR LAKE ROAD, ST. LOUIS PARK, MN, 55416

Signature of
Role Plan administrator
Date 2013-07-01
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-01
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
THOM AGENCY EMPLOYEES 401K PLAN AND TRUST 2011 411670693 2012-06-13 GREAT PLAIN STATES INSURANCE AGENCY 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524210
Sponsor’s telephone number 9525938717
Plan sponsor’s DBA name THOM AGENCY
Plan sponsor’s address 5851 CEDAR LAKE ROAD, ST. LOUIS PARK, MN, 55416

Plan administrator’s name and address
Administrator’s EIN 411670693
Plan administrator’s name GREAT PLAIN STATES INSURANCE AGENCY
Plan administrator’s address 5851 CEDAR LAKE ROAD, ST. LOUIS PARK, MN, 55416
Administrator’s telephone number 9525938717

Signature of
Role Plan administrator
Date 2012-06-13
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-13
Name of individual signing ROBERT CLEMANTS
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Robert E Clemants Chief Executive Officer 40 S Elm St, Waconia, MN 55387, USA

Filing

Filing Name Filing date
Administrative Dissolution - Business Corporation (Domestic) 2022-01-25
Registered Office and/or Agent - Business Corporation (Domestic) 2003-01-31
Original Filing - Business Corporation (Domestic) 1990-05-18
Business Corporation (Domestic) Business Name (Business Name: Great Plain States Insurance Agency, Inc.) 1990-05-18

Related by officers

No related officers

Related by address

11527 Fetterly Road W, Minnetonka, MN 55305, USA

American Agency, Inc.

40 S Elm St, Waconia, MN 55387, USA

American Thom Agency Thom Agency

Date of last update: 26 Sep 2024

Sources: Minnesota's Official State Website

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