THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2021
|
410873104
|
2024-05-15
|
THE WAYSIDE HOUSE, INC,
|
125
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9524265626
|
Plan
sponsor’s DBA name |
WAYSIDE RECOVERY CENTER
|
Plan sponsor’s mailing address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Number of participants as of the end of the plan year
Active participants |
132 |
Number of
participants
with
account balances as of the end of the plan year |
132 |
Signature of
Role |
Plan administrator |
Date |
2024-05-15 |
Name of individual signing |
ANDREA VASQUEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2021
|
410873104
|
2022-10-17
|
THE WAYSIDE HOUSE, INC,
|
125
|
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9524265626
|
Plan
sponsor’s DBA name |
WAYSIDE RECOVERY CENTER
|
Plan sponsor’s mailing address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Number of participants as of the end of the plan year
Active participants |
132 |
Number of
participants
with
account balances as of the end of the plan year |
132 |
Signature of
Role |
Plan administrator |
Date |
2022-10-17 |
Name of individual signing |
ANDREA VASQUEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-10-17 |
Name of individual signing |
ANDREA VASQUEZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2020
|
410873104
|
2021-06-29
|
THE WAYSIDE HOUSE, INC.
|
112
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9524265626
|
Plan
sponsor’s DBA name |
WAYSIDE RECOVERY CENTER
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Signature of
Role |
Plan administrator |
Date |
2021-06-29 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2019
|
410873104
|
2020-06-29
|
THE WAYSIDE HOUSE, INC.
|
110
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9524265626
|
Plan
sponsor’s DBA name |
WAYSIDE RECOVERY CENTER
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Signature of
Role |
Plan administrator |
Date |
2020-06-29 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-06-29 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2018
|
410873104
|
2019-05-21
|
THE WAYSIDE HOUSE, INC.
|
109
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9524265626
|
Plan
sponsor’s DBA name |
WAYSIDE RECOVERY CENTER
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Signature of
Role |
Plan administrator |
Date |
2019-05-21 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-05-21 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2017
|
410873104
|
2018-07-19
|
THE WAYSIDE HOUSE, INC.
|
92
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9529265626
|
Plan
sponsor’s DBA name |
WAYSIDE RECOVERY CENTER
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Signature of
Role |
Plan administrator |
Date |
2018-07-19 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-07-19 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2016
|
410873104
|
2017-03-21
|
THE WAYSIDE HOUSE, INC.
|
93
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9529265626
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Signature of
Role |
Plan administrator |
Date |
2017-03-21 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2015
|
410873104
|
2016-04-13
|
THE WAYSIDE HOUSE, INC.
|
77
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9529265626
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, ST LOUIS PARK, MN, 554162504
|
Signature of
Role |
Plan administrator |
Date |
2016-04-13 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2014
|
410873104
|
2015-03-23
|
THE WAYSIDE HOUSE, INC.
|
70
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9529265626
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, S. LOUIS PARK, MN, 55416
|
Signature of
Role |
Plan administrator |
Date |
2015-03-23 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-03-23 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE WAYSIDE HOUSE, INC. 403(B) PLAN
|
2013
|
410873104
|
2015-03-20
|
THE WAYSIDE HOUSE, INC.
|
67
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-01-28
|
Business code |
624100
|
Sponsor’s telephone number |
9524057634
|
Plan sponsor’s
address |
3705 PARK CENTER BLVD, ST. LOUIS PARK, MN, 55416
|
Signature of
Role |
Plan administrator |
Date |
2015-03-20 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-03-20 |
Name of individual signing |
DAN URSIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|