FRAZEE CARE CENTER 401(K) PLAN
|
2023
|
208729268
|
2024-07-22
|
LSS OF FRAZEE, LLC
|
66
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
2183344501
|
Plan sponsor’s
address |
219 WEST MAPLE AVENUE, FRAZEE, MN, 56544
|
Signature of
Role |
Plan administrator |
Date |
2024-07-22 |
Name of individual signing |
AMBER ROGOTZKE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FRAZEE CARE CENTER 401(K) PLAN
|
2022
|
208729268
|
2023-06-30
|
LSS OF FRAZEE, LLC
|
52
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
2183344501
|
Plan sponsor’s
address |
219 WEST MAPLE AVENUE, FRAZEE, MN, 56544
|
Signature of
Role |
Plan administrator |
Date |
2023-06-30 |
Name of individual signing |
AMBER ROGOTZKE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FRAZEE CARE CENTER 401(K) PLAN
|
2021
|
208729268
|
2022-07-27
|
LSS OF FRAZEE, LLC
|
94
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
2183344501
|
Plan sponsor’s
address |
219 WEST MAPLE AVENUE, FRAZEE, MN, 56544
|
Signature of
Role |
Plan administrator |
Date |
2022-07-27 |
Name of individual signing |
AMBER ROGOTZKE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FRAZEE CARE CENTER 401(K) PLAN
|
2020
|
208729268
|
2021-06-08
|
LSS OF FRAZEE, LLC
|
67
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
2183344501
|
Plan sponsor’s
address |
219 WEST MAPLE AVENUE, FRAZEE, MN, 56544
|
Signature of
Role |
Plan administrator |
Date |
2021-06-08 |
Name of individual signing |
AMBER ROGOTZKE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FRAZEE CARE CENTER 401(K) PLAN
|
2019
|
208729268
|
2020-07-09
|
LSS OF FRAZEE, LLC
|
68
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
2183344501
|
Plan sponsor’s
address |
219 WEST MAPLE AVENUE, FRAZEE, MN, 56544
|
Signature of
Role |
Plan administrator |
Date |
2020-07-09 |
Name of individual signing |
AMBER ROGOTZKE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FRAZEE CARE CENTER 401(K) PLAN
|
2018
|
208729268
|
2019-06-07
|
LSS OF FRAZEE, LLC
|
76
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
2183344501
|
Plan sponsor’s
address |
219 WEST MAPLE AVENUE, FRAZEE, MN, 56544
|
Signature of
Role |
Plan administrator |
Date |
2019-06-07 |
Name of individual signing |
AMBER ROGOTZKE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FRAZEE CARE CENTER 401(K) PLAN
|
2017
|
208729268
|
2018-10-10
|
LSS OF FRAZEE, LLC
|
83
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
2183344501
|
Plan sponsor’s
address |
219 WEST MAPLE AVENUE, FRAZEE, MN, 56544
|
|
FRAZEE CARE CENTER 401(K) PLAN
|
2016
|
208729268
|
2017-10-02
|
LSS OF FRAZEE, LLC
|
87
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
2183344501
|
Plan sponsor’s
address |
219 WEST MAPLE AVENUE, FRAZEE, MN, 56544
|
|
FRAZEE CARE CENTER 401(K) PLAN
|
2015
|
208729268
|
2016-08-31
|
LSS OF FRAZEE, LLC
|
56
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
7632258622
|
Plan sponsor’s
address |
219 W MAPLE AVE., FRAZEE, MN, 56544
|
Signature of
Role |
Plan administrator |
Date |
2016-08-31 |
Name of individual signing |
SHANNON THOMPSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-08-31 |
Name of individual signing |
SHANNON THOMPSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FRAZEE CARE CENTER 401(K) PLAN
|
2014
|
208729268
|
2015-10-15
|
LSS OF FRAZEE, LLC
|
55
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1999-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
2183344501
|
Plan sponsor’s
address |
219 W MAPLE AVE., FRAZEE, MN, 56544
|
Signature of
Role |
Plan administrator |
Date |
2015-10-15 |
Name of individual signing |
KYLIE HANSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-15 |
Name of individual signing |
KYLIE HANSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|