|
PICC STAT 401(K) PLAN
|
2011
|
202065730
|
2012-08-02
|
PICC STAT
|
11
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
7635860614
|
| Plan sponsor’s
address |
7671 CENTRAL AVENUE NE, FRIDLEY, MN, 55432
|
Plan administrator’s name and address
| Administrator’s EIN |
202065730 |
| Plan administrator’s name |
PICC STAT |
| Plan administrator’s
address |
7671 CENTRAL AVENUE NE, FRIDLEY, MN, 55432 |
| Administrator’s telephone number |
7635860614 |
Signature of
| Role |
Plan administrator |
| Date |
2012-08-02 |
| Name of individual signing |
DOYLE L RANDALL CFO |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PICC STAT 401(K) PLAN
|
2010
|
202065730
|
2011-10-16
|
PICC STAT
|
15
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
7635860614
|
| Plan sponsor’s
address |
7671 CENTRAL AVENUE NE, FRIDLEY, MN, 55432
|
Plan administrator’s name and address
| Administrator’s EIN |
202065730 |
| Plan administrator’s name |
PICC STAT |
| Plan administrator’s
address |
7671 CENTRAL AVENUE NE, FRIDLEY, MN, 55432 |
| Administrator’s telephone number |
7635860614 |
|
|
PICC STAT 401(K) PLAN
|
2009
|
202065730
|
2011-01-11
|
PICC STAT
|
16
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
7635860614
|
| Plan sponsor’s
address |
7671 CENTRAL AVENUE NE, FRIDLEY, MN, 55432
|
Plan administrator’s name and address
| Administrator’s EIN |
202065730 |
| Plan administrator’s name |
PICC STAT |
| Plan administrator’s
address |
7671 CENTRAL AVENUE NE, FRIDLEY, MN, 55432 |
| Administrator’s telephone number |
7635860614 |
Signature of
| Role |
Plan administrator |
| Date |
2011-01-11 |
| Name of individual signing |
TIMOTHY WERNER |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PICC STAT 401(K) PLAN
|
2009
|
202065730
|
2010-10-14
|
PICC STAT
|
16
|
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2007-01-01
|
| Business code |
623000
|
| Sponsor’s telephone number |
7635860614
|
| Plan sponsor’s
address |
7671 CENTRAL AVENUE NE, FRIDLEY, MN, 55432
|
Plan administrator’s name and address
| Administrator’s EIN |
202065730 |
| Plan administrator’s name |
PICC STAT |
| Plan administrator’s
address |
7671 CENTRAL AVENUE NE, FRIDLEY, MN, 55432 |
| Administrator’s telephone number |
7635860614 |
|
