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  5. Community Health Information Collaborative

Community Health Information Collaborative

Company Details

Name: Community Health Information Collaborative
Jurisdiction: Minnesota
Legal type: Nonprofit Corporation (Domestic)
Status: Inactive
Date formed: 28 Apr 1999 (26 years ago)
Company Number: b39f228d-b7d4-e011-a886-001ec94ffe7f
File Number: 1T-336
Registered Office Address: 404 W Superior Str #250, Duluth, MN 55802, USA
ZIP code: 55802
County: St. Louis County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COMMUNITY HEALTH INFORMATION COLLABORATIVE 403(B) PLAN 2014 411964379 2015-10-15 COMMUNITY HEALTH INFORMATION COLLABORATIVE 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 611000
Sponsor’s telephone number 2186255515
Plan sponsor’s address 404 WEST SUPERIOR STREET, SUITE 250, DULUTH, MN, 55802
COMMUNITY HEALTH INFORMATION COLLABORATIVE 403(B) PLAN 2013 411964379 2014-10-10 COMMUNITY HEALTH INFORMATION COLLABORATIVE 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 611000
Sponsor’s telephone number 2186255515
Plan sponsor’s address 404 WEST SUPERIOR STREET, SUITE 250, DULUTH, MN, 55802

Signature of
Role Plan administrator
Date 2014-10-10
Name of individual signing CHERYL STEPHENS
Valid signature Filed with authorized/valid electronic signature
COMMUNITY HEALTH INFORMATION COLLABORATIVE 403(B) PLAN 2012 411964379 2013-08-26 COMMUNITY HEALTH INFORMATION COLLABORATIVE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 611000
Sponsor’s telephone number 2186255515
Plan sponsor’s address 404 WEST SUPERIOR STREET, SUITE 250, DULUTH, MN, 55802

Signature of
Role Plan administrator
Date 2013-08-26
Name of individual signing CHERYL STEPHENS
Valid signature Filed with authorized/valid electronic signature
COMMUNITY HEALTH INFORMATION COLLABORATIVE 403(B) PLAN 2011 411964379 2012-10-04 COMMUNITY HEALTH INFORMATION COLLABORATIVE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 611000
Sponsor’s telephone number 2186255515
Plan sponsor’s address 404 WEST SUPERIOR STREET, SUITE 250, DULUTH, MN, 55802

Plan administrator’s name and address
Administrator’s EIN 411964379
Plan administrator’s name COMMUNITY HEALTH INFORMATION COLLABORATIVE
Plan administrator’s address 404 WEST SUPERIOR STREET, SUITE 250, DULUTH, MN, 55802
Administrator’s telephone number 2186255515

Signature of
Role Plan administrator
Date 2012-10-04
Name of individual signing CHERYL STEPHENS
Valid signature Filed with authorized/valid electronic signature
COMMUNITY HEALTH INFORMATION COLLABORATIVE 403(B) PLAN 2010 411964379 2011-08-31 COMMUNITY HEALTH INFORMATION COLLABORATIVE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 611000
Sponsor’s telephone number 2186255515
Plan sponsor’s address 404 WEST SUPERIOR STREET, SUITE 250, DULUTH, MN, 55802

Plan administrator’s name and address
Administrator’s EIN 411964379
Plan administrator’s name COMMUNITY HEALTH INFORMATION COLLABORATIVE
Plan administrator’s address 404 WEST SUPERIOR STREET, SUITE 250, DULUTH, MN, 55802
Administrator’s telephone number 2186255515

Signature of
Role Plan administrator
Date 2011-08-31
Name of individual signing CHERYL M STEPHENS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-08-31
Name of individual signing CHERYL M STEPHENS
Valid signature Filed with authorized/valid electronic signature
COMMUNITY HEALTH INFORMATION COLLABORATIVE 403(B) PLAN 2009 411964379 2010-10-14 COMMUNITY HEALTH INFORMATION COLLABORATIVE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-05-01
Business code 611000
Sponsor’s telephone number 2186255515
Plan sponsor’s address 404 WEST SUPERIOR STREET, SUITE 250, DULUTH, MN, 55802

Plan administrator’s name and address
Administrator’s EIN 411964379
Plan administrator’s name COMMUNITY HEALTH INFORMATION COLLABORATIVE
Plan administrator’s address 404 WEST SUPERIOR STREET, SUITE 250, DULUTH, MN, 55802
Administrator’s telephone number 2186255515

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing CHERYL M STEPHENS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-13
Name of individual signing CHERYL M STEPHENS
Valid signature Filed with authorized/valid electronic signature

President

Name Role Address
Cheryl Stephens President 404 W Superior Str #250, Duluth, MN 55802, USA

Filing

Filing Name Filing date
Annual Reinstatement - Nonprofit Corporation (Domestic) 2013-05-08
Involuntary Dissolution - Nonprofit Corporation (Domestic) 2013-02-27
Registered Office and/or Agent - Nonprofit Corporation (Domestic) 2002-10-16
Original Filing - Nonprofit Corporation (Domestic) 1999-04-28
Nonprofit Corporation (Domestic) Business Name (Business Name: Community Health Information Collaborative) 1999-04-28

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Date of last update: 02 Oct 2024

Sources: Minnesota's Official State Website

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