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Jacobsen Metal Fabrication, Inc.

Company Details

Name: Jacobsen Metal Fabrication, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 12 Feb 2004 (21 years ago)
Company Number: cafb3fce-87d4-e011-a886-001ec94ffe7f
File Number: 788264-2
Registered Office Address: 1905 1st Ave, Mankato, MN 56001, USA
Principal Executive Office Address: 1905 1ST AVE, MANKATO, MN 56001, USA
ZIP code: 56001
County: Blue Earth County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JACOBSEN METAL FABRICATION PROFIT SHARING AND 401(K) PLAN 2014 411481859 2015-06-12 JACOBSEN METAL FABRICATION, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 332900
Sponsor’s telephone number 5073874253
Plan sponsor’s address PO BOX 1986, 1905 FIRST AVE., MANKATO, MN, 560021986

Signature of

Role Plan administrator
Date 2015-06-12
Name of individual signing SONJA M JACOBSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-12
Name of individual signing SONJA M JACOBSEN
Valid signature Filed with authorized/valid electronic signature
JACOBSEN METAL FABRICATION PROFIT SHARING AND 401(K) PLAN 2014 411481859 2015-12-15 JACOBSEN METAL FABRICATION, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 332900
Sponsor’s telephone number 5073874253
Plan sponsor’s address PO BOX 1986, 1905 FIRST AVE., MANKATO, MN, 560021986

Signature of

Role Plan administrator
Date 2015-12-15
Name of individual signing SONJA M JACOBSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-12-15
Name of individual signing SONJA M JACOBSEN
Valid signature Filed with authorized/valid electronic signature
JACOBSEN METAL FABRICATION PROFIT SHARING AND 401(K) PLAN 2013 411481859 2014-05-28 JACOBSEN METAL FABRICATION, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 332900
Sponsor’s telephone number 5073874253
Plan sponsor’s address PO BOX 1986, 1905 FIRST AVE., MANKATO, MN, 560021986

Signature of

Role Plan administrator
Date 2014-05-28
Name of individual signing SONJA JACOBSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-28
Name of individual signing SONJA JACOBSEN
Valid signature Filed with authorized/valid electronic signature
JACOBSEN METAL FABRICATION PROFIT SHARING AND 401(K) PLAN 2012 411481859 2013-07-09 JACOBSEN METAL FABRICATION, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 332900
Sponsor’s telephone number 5073874253
Plan sponsor’s address PO BOX 1986, 1905 FIRST AVE., MANKATO, MN, 560021986

Signature of

Role Plan administrator
Date 2013-07-09
Name of individual signing SONJA JACOBSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-09
Name of individual signing SONJA JACOBSEN
Valid signature Filed with authorized/valid electronic signature
JACOBSEN METAL FABRICATION PROFIT SHARING AND 401(K) PLAN 2011 411481859 2012-07-10 JACOBSEN METAL FABRICATION, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 332900
Sponsor’s telephone number 5073874253
Plan sponsor’s address PO BOX 1986, 1905 FIRST AVE., MANKATO, MN, 560021986

Plan administrator’s name and address

Administrator’s EIN 411481859
Plan administrator’s name JACOBSEN METAL FABRICATION, INC.
Plan administrator’s address PO BOX 1986, 1905 FIRST AVE., MANKATO, MN, 560021986
Administrator’s telephone number 5073874253

Signature of

Role Plan administrator
Date 2012-07-10
Name of individual signing SONJA JACOBSEN
Valid signature Filed with authorized/valid electronic signature
JACOBSEN METAL FABRICATION PROFIT SHARING AND 401(K) PLAN 2009 411481859 2010-10-15 JACOBSEN METAL FABRICATION, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 332900
Sponsor’s telephone number 5073874253
Plan sponsor’s mailing address PO BOX 1986, MANKATO, MN, 560021986
Plan sponsor’s address 1905 FIRST AVE., MANKATO, MN, 560021986

Plan administrator’s name and address

Administrator’s EIN 411481859
Plan administrator’s name JACOBSEN METAL FABRICATION, INC.
Plan administrator’s address PO BOX 1986, MANKATO, MN, 560021986
Administrator’s telephone number 5073874253

Number of participants as of the end of the plan year

Active participants 6
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 3
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 9
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2010-10-15
Name of individual signing REBECCA FISHER
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
JOHN JACOBSEN Chief Executive Officer 485 FOREST LANE, NORTH MANKATO, MN 56003, USA

Filing

Filing Name Filing date
Intent to Dissolve - Business Corporation (Domestic) 2015-12-29
Dissolution - Business Corporation (Domestic) 2015-12-29
Original Filing - Business Corporation (Domestic) (Business Name: Jacobsen Metal Fabrication, Inc.) 2004-02-12

Date of last update: 26 Sep 2024

Sources: Minnesota's Official State Website