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  5. Robert J. Petersen Agency, Inc.

Robert J. Petersen Agency, Inc.

Company Details

Name: Robert J. Petersen Agency, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Active / In Good Standing
Date formed: 19 Jun 2002 (23 years ago)
Company Number: ded2d9ba-9dd4-e011-a886-001ec94ffe7f
File Number: 12F-580
Registered Office Address: 3260 Rice Str, Shoreview, MN 55126, USA
Principal Executive Office Address: 4401 Oakmede, White Bear Lake, MN 55110, USA
ZIP code: 55126
County: Ramsey County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROBERT J PETERSEN AGENCY INC 401(K) PROFIT SHARING PLAN & TRUST 2019 431966033 2020-06-18 ROBERT J PETERSEN AGENCY INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089

Signature of
Role Plan administrator
Date 2020-06-18
Name of individual signing ROBERT PETERSEN
Valid signature Filed with authorized/valid electronic signature
ROBERT J PETERSEN AGENCY INC 401 K PROFIT SHARING PLAN TRUST 2018 431966033 2019-06-05 ROBERT J PETERSEN AGENCY INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089

Signature of
Role Plan administrator
Date 2019-06-05
Name of individual signing ROBERT PETERSEN
Valid signature Filed with authorized/valid electronic signature
ROBERT J PETERSEN AGENCY INC 401 K PROFIT SHARING PLAN TRUST 2017 431966033 2018-07-09 ROBERT J PETERSEN AGENCY INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089

Signature of
Role Plan administrator
Date 2018-07-09
Name of individual signing ROBERT PETERSEN
Valid signature Filed with authorized/valid electronic signature
ROBERT J PETERSEN AGENCY INC 401 K PROFIT SHARING PLAN TRUST 2016 431966033 2017-07-15 ROBERT J PETERSEN AGENCY INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089

Signature of
Role Plan administrator
Date 2017-07-15
Name of individual signing ROBERT PETERSEN
Valid signature Filed with authorized/valid electronic signature
ROBERT J PETERSEN AGENCY INC 401 K PROFIT SHARING PLAN TRUST 2015 431966033 2016-07-27 ROBERT J PETERSEN AGENCY INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089

Signature of
Role Plan administrator
Date 2016-07-27
Name of individual signing ROBERT PETERSEN
Valid signature Filed with authorized/valid electronic signature
ROBERT J PETERSEN AGENCY INC 401 K PROFIT SHARING PLAN TRUST 2014 431966033 2015-07-30 ROBERT J PETERSEN AGENCY INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089

Signature of
Role Plan administrator
Date 2015-07-30
Name of individual signing ROBERT PETERSEN
Valid signature Filed with authorized/valid electronic signature
ROBERT J PETERSEN AGENCY INC 401 K PROFIT SHARING PLAN TRUST 2013 431966033 2014-07-07 ROBERT J PETERSEN AGENCY INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089

Signature of
Role Plan administrator
Date 2014-07-07
Name of individual signing ROBERT PETERSEN
Valid signature Filed with authorized/valid electronic signature
ROBERT J PETERSEN AGENCY INC 401 K PROFIT SHARING PLAN TRUST 2012 431966033 2013-07-07 ROBERT J PETERSEN AGENCY INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089

Signature of
Role Plan administrator
Date 2013-07-07
Name of individual signing ROBERT J PETERSEN AGENCY INC
Valid signature Filed with authorized/valid electronic signature
ROBERT J PETERSEN AGENCY INC 401 K PROFIT SHARING PLAN TRUST 2011 431966033 2012-07-23 ROBERT J PETERSEN AGENCY INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089

Plan administrator’s name and address
Administrator’s EIN 431966033
Plan administrator’s name ROBERT J PETERSEN AGENCY INC
Plan administrator’s address 3260 RICE ST STE A, SHOREVIEW, MN, 551263089
Administrator’s telephone number 6514844480

Signature of
Role Plan administrator
Date 2012-07-23
Name of individual signing ROBERT J PETERSEN AGENCY INC
Valid signature Filed with authorized/valid electronic signature
ROBERT J PETERSEN AGENCY INC 401 K PROFIT SHARING PLAN TRUST 2010 431966033 2011-07-28 ROBERT J PETERSEN AGENCY INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-06-02
Business code 524210
Sponsor’s telephone number 6514844480
Plan sponsor’s address 3260 RICE ST, SHOREVIEW, MN, 55126

Plan administrator’s name and address
Administrator’s EIN 431966033
Plan administrator’s name ROBERT J PETERSEN AGENCY INC
Plan administrator’s address 3260 RICE ST, SHOREVIEW, MN, 55126
Administrator’s telephone number 6514844480

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing ROBERT J PETERSEN AGENCY INC
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Robert J Petersen Chief Executive Officer 4401 Oakmede, White Bear Lake, MN 55110, USA

Filing

Filing Name Filing date
Registered Office and/or Agent - Business Corporation (Domestic) 2009-01-29
Original Filing - Business Corporation (Domestic) 2002-06-19
Business Corporation (Domestic) Business Name (Business Name: Robert J. Petersen Agency, Inc.) 2002-06-19

Related by officers

Robert J Petersen

Superior Building, LLC Petersen Consulting Enterprises

Related by address

3260 Rice Str, Shoreview, MN 55126, USA

Chris Bale Agency Inc.

Date of last update: 27 Sep 2024

Sources: Minnesota's Official State Website

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