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CUSTOM Rx LLC

CUSTOM Rx LLC

Company Details

Name:	CUSTOM Rx LLC
Jurisdiction:	Minnesota
Legal type:	Limited Liability Company (Domestic)
Status:	Inactive
Date formed:	15 Jul 2009 (15 years ago)
Company Number:	a8b76251-94d4-e011-a886-001ec94ffe7f
File Number:	3415839-2
Registered Office Address:	6519 Nicollet AVe S #201, Richfield, MN 55423, USA
Principal Executive Office Address:	6519 Nicollet Ave S #201, Richfield, MN 55423, USA
Business Mailing Address:	35 Old Avon Village PMB 196, Avon, CT 06001, USA
ZIP code:	55423
County:	Hennepin County
Place of Formation:	Minnesota

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

CUSTOM RX, LLC 401K PROFIT SHARING PLAN & TRUST

2015

272120448

2016-10-16

CUSTOM RX, LLC

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	325410
Sponsor’s telephone number	6128432063
Plan sponsor’s address	6519 NICOLLET AVE S 201, RICHFIELD, MN, 55423

Signature of

Role	Plan administrator
Date	2016-10-16
Name of individual signing	ROY KATZ
Valid signature	Filed with authorized/valid electronic signature

CUSTOM RX, LLC 401K PROFIT SHARING PLAN & TRUST

2014

272120448

2015-06-15

CUSTOM RX, LLC

6

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	325410
Sponsor’s telephone number	6128432063
Plan sponsor’s address	6519 NICOLLET AVE S # 201, RICHFIELD, MN, 55423

Signature of

Role	Plan administrator
Date	2015-06-15
Name of individual signing	ROY KATZ
Valid signature	Filed with authorized/valid electronic signature

CUSTOM RX, LLC 401K PROFIT SHARING PLAN & TRUST

2013

272120448

2014-07-08

CUSTOM RX, LLC

10

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	325410
Sponsor’s telephone number	6128432063
Plan sponsor’s address	6519 NICOLLET AVE STE 201, RICHFIELD, MN, 55423

Signature of

Role	Plan administrator
Date	2014-07-08
Name of individual signing	ROY KATZ
Valid signature	Filed with authorized/valid electronic signature

CUSTOM RX LLC 401 K PROFIT SHARING PLAN TRUST

2012

272120448

2013-06-12

CUSTOM RX LLC

7

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2012-01-01
Business code	325410
Sponsor’s telephone number	6128662211
Plan sponsor’s address	6519 NICOLLET AVE STE 201, RICHFIELD, MN, 55423

Signature of

Role	Plan administrator
Date	2013-06-12
Name of individual signing	CUSTOM RX LLC
Valid signature	Filed with authorized/valid electronic signature

Manager

Name	Role	Address
Roy Katz	Manager	6519 Nicollet Ave S #201, Richfield, MN 55423, USA

Filing

Filing Name	Filing date
Conversion to 322C Due to Statute Mandate – Limited Liability Company (Domestic)	2018-01-01
Annual Reinstatement - Limited Liability Company (Domestic)	2012-12-20
Administrative Termination - Limited Liability Company (Domestic)	2012-08-03
Original Filing - Limited Liability Company (Domestic)	2009-07-15
Limited Liability Company (Domestic) Business Name (Business Name: CUSTOM Rx LLC)	2009-07-15

Date of last update: 01 Jan 2025

Sources: Minnesota's Official State Website