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  5. Associate Optometry, P.A.

Associate Optometry, P.A.

Company Details

Name: Associate Optometry, P.A.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 07 Oct 1996 (28 years ago)
Company Number: a3c10457-aad4-e011-a886-001ec94ffe7f
File Number: 9J-37
Registered Office Address: 1307 Albion Ave #102, Fairmont, MN 56031, USA
Principal Executive Office Address: 1307 ALBION AVE STE 102, FAIRMONT, MN 56031–1850, USA
ZIP code: 56031
County: Martin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2023 411854214 2024-09-02 ASSOCIATE OPTOMETRY, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 102, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2024-09-03
Name of individual signing SPENCER SEIBERT
Valid signature Filed with authorized/valid electronic signature
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2022 411854214 2023-07-13 ASSOCIATE OPTOMETRY, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 102, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2023-07-13
Name of individual signing SPENCER SEIBERT
Valid signature Filed with authorized/valid electronic signature
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2021 411854214 2022-04-11 ASSOCIATE OPTOMETRY, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 102, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2022-04-11
Name of individual signing SPENCER SEIBERT
Valid signature Filed with authorized/valid electronic signature
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2020 411854214 2021-03-05 ASSOCIATE OPTOMETRY, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 102, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2021-03-05
Name of individual signing SPENCER SEIBERT
Valid signature Filed with authorized/valid electronic signature
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2019 411854214 2020-07-01 ASSOCIATE OPTOMETRY, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 102, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2020-07-01
Name of individual signing SPENCER SEIBERT
Valid signature Filed with authorized/valid electronic signature
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2018 411854214 2019-06-07 ASSOCIATE OPTOMETRY, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 102, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2019-06-07
Name of individual signing SPENCER SEIBERT
Valid signature Filed with authorized/valid electronic signature
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2017 411854214 2018-03-27 ASSOCIATE OPTOMETRY, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 102, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2018-03-27
Name of individual signing PAUL SEIBERT
Valid signature Filed with authorized/valid electronic signature
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2016 411854214 2017-02-06 ASSOCIATE OPTOMETRY, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 102, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2017-02-06
Name of individual signing PAUL SEIBERT
Valid signature Filed with authorized/valid electronic signature
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2015 414854214 2016-03-03 ASSOCIATE OPTOMETRY, P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 102, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2016-03-03
Name of individual signing PAUL SEIBERT
Valid signature Filed with authorized/valid electronic signature
ASSOCIATE OPTOMETRY, P.A. 401(K) PLAN AND TRUST 2014 414854214 2015-02-12 ASSOCIATE OPTOMETRY, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 621320
Sponsor’s telephone number 5072384228
Plan sponsor’s address 1307 ALBION AVENUE, SUITE 120, FAIRMONT, MN, 56031

Signature of
Role Plan administrator
Date 2015-02-12
Name of individual signing PAUL SEIBERT
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
James P Busche Chief Executive Officer 1307 ALBION AVE STE 102, FAIRMONT, MN 56031–1850, USA

Filing

Filing Name Filing date
Original Filing - Business Corporation (Domestic) (Business Name: Associate Optometry, P.A.)Professional Service - Optometry 1996-10-07

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 26 Sep 2024

Sources: Minnesota's Official State Website

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