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  5. AJ Moonlighting PA

AJ Moonlighting PA

Company Details

Name: AJ Moonlighting PA
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 25 Feb 2009 (16 years ago)
Company Number: bf8c9855-93d4-e011-a886-001ec94ffe7f
File Number: 3226125-2
Registered Office Address: 6076 Woody Ln NE, Fridley, MN 55432, USA
Principal Executive Office Address: PMB 242, 6385 OLD SHADY OAK RD STE 250, EDEN PRAIRIE, MN 55344–7705, USA
ZIP code: 55432
County: Anoka County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AJ MOONLIGHTING, PA 401K PLAN 2018 264281730 2019-06-28 AJ MOONLIGHTING, PA 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 541600
Sponsor’s telephone number 6124127260
Plan sponsor’s address 6076 WOODY LANE NE, FRIDLEY, MN, 55432

Signature of
Role Plan administrator
Date 2019-06-28
Name of individual signing ANDREA JOLLEY
Valid signature Filed with authorized/valid electronic signature
AJ MOONLIGHTING, PA 401K PLAN 2017 264281730 2018-09-04 AJ MOONLIGHTING, PA 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 541600
Sponsor’s telephone number 6124127260
Plan sponsor’s address 6076 WOODY LANE NE, FRIDLEY, MN, 55432

Signature of
Role Plan administrator
Date 2018-09-04
Name of individual signing ANDREA JOLLEY
Valid signature Filed with authorized/valid electronic signature
AJ MOONLIGHTING, PA 401K PLAN 2016 264281730 2017-06-22 AJ MOONLIGHTING, PA 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 541600
Sponsor’s telephone number 6124127260
Plan sponsor’s address 6076 WOODY LANE NE, FRIDLEY, MN, 55432

Signature of
Role Plan administrator
Date 2017-06-22
Name of individual signing ANDREA JOLLEY
Valid signature Filed with authorized/valid electronic signature
AJ MOONLIGHTING, PA 401K PLAN 2015 264281730 2016-06-03 AJ MOONLIGHTING, PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 541600
Sponsor’s telephone number 6124127260
Plan sponsor’s address 6076 WOODY LANE NE, FRIDLEY, MN, 55432

Signature of
Role Plan administrator
Date 2016-06-03
Name of individual signing ANDREA JOLLEY
Valid signature Filed with authorized/valid electronic signature
AJ MOONLIGHTING, PA 401K PLAN 2014 264281730 2015-07-27 AJ MOONLIGHTING, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 541600
Sponsor’s telephone number 6124127260
Plan sponsor’s address 6076 WOODY LANE NE, FRIDLEY, MN, 55432

Signature of
Role Plan administrator
Date 2015-07-27
Name of individual signing ANDREA JOLLEY
Valid signature Filed with authorized/valid electronic signature
AJ MOONLIGHTING, PA 401K PLAN 2013 264281730 2014-09-09 AJ MOONLIGHTING, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 541600
Sponsor’s telephone number 6124127260
Plan sponsor’s address 6076 WOODY LANE NE, FRIDLEY, MN, 55432

Signature of
Role Plan administrator
Date 2014-09-09
Name of individual signing JANE SPANN
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Andrea Jolley Chief Executive Officer PMB 242, 6385 OLD SHADY OAK RD STE 250, EDEN PRAIRIE, MN 55344–7705, USA

Filing

Filing Name Filing date
Amendment - Business Corporation (Domestic) 2015-10-05
Annual Reinstatement - Business Corporation (Domestic) 2014-12-01
Administrative Dissolution Name Hold Release - Business Corporation (Domestic) 2013-08-06
Administrative Dissolution - Business Corporation (Domestic) 2012-08-01
Original Filing - Business Corporation (Domestic) (Business Name: AJ Moonlighting PA)Professional Service - Medicine & Surgery 2009-02-25

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Date of last update: 30 Sep 2024

Sources: Minnesota's Official State Website

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