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  5. AVICENNA TECHNOLOGY, INC.

AVICENNA TECHNOLOGY, INC.

Company Details

Name: AVICENNA TECHNOLOGY, INC.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 03 Mar 2000 (25 years ago)
Company Number: b837ebc2-b7d4-e011-a886-001ec94ffe7f
File Number: 11B-147
Registered Office Address: 2780 Snelling Avenue N, Suite 101, Roseville, MN 55113, USA
Principal Executive Office Address: 1100 CASSATT RD, BERWYN, PA 19312–1177, USA
ZIP code: 55113
County: Ramsey County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AVICENNA TECHNOLOGY 401(K) PLAN 2012 770537213 2013-01-28 AVICENNA TECHNOLOGY, INC. 119
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 339110
Sponsor’s telephone number 3202695588
Plan sponsor’s address 1602 BENSON ROAD, MONTEVIDEO, MN, 56265

Signature of
Role Plan administrator
Date 2013-01-28
Name of individual signing DANIEL STACKEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-01-28
Name of individual signing DANIEL STACKEN
Valid signature Filed with authorized/valid electronic signature
AVICENNA TECHNOLOGY 401(K) PLAN 2011 770537213 2013-01-09 AVICENNA TECHNOLOGY, INC. 119
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 339110
Sponsor’s telephone number 3202695588
Plan sponsor’s address 1602 BENSON ROAD, MONTEVIDEO, MN, 56265

Plan administrator’s name and address
Administrator’s EIN 770537213
Plan administrator’s name AVICENNA TECHNOLOGY, INC.
Plan administrator’s address 1602 BENSON ROAD, MONTEVIDEO, MN, 56265
Administrator’s telephone number 3202695588

Signature of
Role Plan administrator
Date 2013-01-09
Name of individual signing DANIEL STACKEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-01-09
Name of individual signing DANIEL STACKEN
Valid signature Filed with authorized/valid electronic signature
AVICENNA TECHNOLOGY 401(K) PLAN 2011 770537213 2012-11-12 AVICENNA TECHNOLOGY, INC. 98
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 339110
Sponsor’s telephone number 3202695588
Plan sponsor’s address 1602 BENSON ROAD, MONTEVIDEO, MN, 56265

Plan administrator’s name and address
Administrator’s EIN 770537213
Plan administrator’s name AVICENNA TECHNOLOGY, INC.
Plan administrator’s address 1602 BENSON ROAD, MONTEVIDEO, MN, 56265
Administrator’s telephone number 3202695588

Signature of
Role Plan administrator
Date 2012-11-12
Name of individual signing DAN STACKEN
Valid signature Filed with authorized/valid electronic signature
AVICENNA TECHNOLOGY 401(K) PLAN 2011 770537213 2012-06-11 AVICENNA TECHNOLOGY, INC. 98
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 339110
Sponsor’s telephone number 3202695588
Plan sponsor’s address 1602 BENSON ROAD, MONTEVIDEO, MN, 56265

Plan administrator’s name and address
Administrator’s EIN 770537213
Plan administrator’s name AVICENNA TECHNOLOGY, INC.
Plan administrator’s address 1602 BENSON ROAD, MONTEVIDEO, MN, 56265
Administrator’s telephone number 3202695588

Signature of
Role Plan administrator
Date 2012-06-11
Name of individual signing DAN STACKEN
Valid signature Filed with authorized/valid electronic signature
AVICENNA TECHNOLOGY 401(K) PLAN 2010 770537213 2011-06-13 AVICENNA TECHNOLOGY, INC. 90
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 339110
Sponsor’s telephone number 3202695588
Plan sponsor’s address 1602 BENSON ROAD, MONTEVIDEO, MN, 56265

Plan administrator’s name and address
Administrator’s EIN 770537213
Plan administrator’s name AVICENNA TECHNOLOGY, INC.
Plan administrator’s address 1602 BENSON ROAD, MONTEVIDEO, MN, 56265
Administrator’s telephone number 3202695588

Signature of
Role Plan administrator
Date 2011-06-13
Name of individual signing DAN STACKEN
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Thomas J. Matway Chief Executive Officer 1100 CASSATT RD, BERWYN, PA 19312–1177, USA

Agent

Name Role
Corporation Service Company Agent

Filing

Filing Name Filing date
Global Registered Office and/or Agent - Business Corporation (Domestic) 2024-10-02
Registered Office and/or Agent - Business Corporation (Domestic) 2000-05-31
Business Corporation (Domestic) Change of Shares 2000-05-31
Business Corporation (Domestic) Restated Articles 2000-05-31
Original Filing - Business Corporation (Domestic) 2000-03-03
Business Corporation (Domestic) Business Name (Business Name: AVICENNA TECHNOLOGY, INC.) 2000-03-03

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Thomas J. Matway

TECHNICAL SERVICES FOR ELECTRONICS, INC.

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2780 Snelling Avenue N, Suite 101, Roseville, MN 55113, USA

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1100 CASSATT RD, BERWYN, PA 19312–1177, USA

AMETEK Technical & Industrial Products, Inc.

Date of last update: 13 Jan 2025

Sources: Minnesota's Official State Website

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