LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP DENTAL AND LIFE INSURANCE PLAN
|
2021
|
411771405
|
2023-10-13
|
LAKESHIRTS INC
|
514
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1998-04-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-10-13 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP VISION PLAN
|
2021
|
411771405
|
2023-10-13
|
LAKESHIRTS INC
|
196
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2011-01-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-10-13 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP MEDICAL PLAN
|
2021
|
411771405
|
2023-10-13
|
LAKESHIRTS INC
|
248
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-04-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-10-13 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP DENTAL AND LIFE INSURANCE PLAN
|
2021
|
411771405
|
2022-07-28
|
LAKESHIRTS INC
|
514
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1998-04-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-07-28 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-07-28 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP VISION PLAN
|
2021
|
411771405
|
2022-07-28
|
LAKESHIRTS INC
|
196
|
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2011-01-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-07-28 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-07-28 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP MEDICAL PLAN
|
2021
|
411771405
|
2022-07-28
|
LAKESHIRTS INC
|
248
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-04-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-07-28 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-07-28 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP VISION PLAN
|
2020
|
411771405
|
2021-07-30
|
LAKESHIRTS INC
|
268
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2011-01-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-07-30 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP MEDICAL PLAN
|
2020
|
411771405
|
2021-07-30
|
LAKESHIRTS INC
|
360
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1998-04-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-07-30 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP DENTAL AND LIFE INSURANCE PLAN
|
2020
|
411771405
|
2021-07-30
|
LAKESHIRTS INC
|
649
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1998-04-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-07-30 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATED GROUP DENTAL AND LIFE INSURANCE PLAN
|
2019
|
411771405
|
2020-09-17
|
LAKESHIRTS INC
|
505
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1998-04-01
|
Business code |
315990
|
Sponsor’s telephone number |
8006272780
|
Plan sponsor’s mailing address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Plan sponsor’s
address |
750 RANDOLPH RD, DETROIT LAKES, MN, 565013701
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-09-17 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-09-17 |
Name of individual signing |
KARA AHLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|