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  5. GENESIS

GENESIS

Company Details

Name: GENESIS
Jurisdiction: Minnesota
Legal type: Assumed Name
Status: Active / In Good Standing
Date formed: 03 Feb 2023 (2 years ago)
Company Number: 098500d6-dfa3-ed11-9068-00155d01c614
File Number: 1371852500028
Principal Place of Business Address: 1601 6th ST SW, WILLMAR, MN 56201, USA
ZIP code: 56201
County: Kandiyohi County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GENESIS 401(K) PLAN AND TRUST 2016 410371070 2017-06-30 GENESIS 116
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-01-01
Business code 115110
Sponsor’s telephone number 5076656270
Plan sponsor’s address 901 N. 4TH ST., LE SUEUR, MN, 56058

Signature of
Role Plan administrator
Date 2017-06-30
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-30
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
GENESIS 401(K) PLAN AND TRUST 2015 410371070 2016-06-24 GENESIS 114
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-01-01
Business code 115110
Sponsor’s telephone number 5076656270
Plan sponsor’s address 901 N. 4TH ST., LE SUEUR, MN, 56058

Signature of
Role Plan administrator
Date 2016-06-24
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-24
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
GENESIS 401(K) PLAN AND TRUST 2014 410371070 2015-07-21 GENESIS 107
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-01-01
Business code 115110
Sponsor’s telephone number 5076656270
Plan sponsor’s address 901 N. 4TH ST., LE SUEUR, MN, 56058

Signature of
Role Plan administrator
Date 2015-07-21
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-21
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
GENESIS 401(K) PLAN AND TRUST 2013 410371070 2014-07-07 GENESIS 112
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-01-01
Business code 115110
Sponsor’s telephone number 5073576868
Plan sponsor’s address 1273 W. DERRYNANE STREET, LE CENTER, MN, 56057

Signature of
Role Plan administrator
Date 2014-07-07
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-07
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
GENESIS 401(K) PLAN AND TRUST 2012 410371070 2013-06-18 GENESIS 107
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-01-01
Business code 115110
Sponsor’s telephone number 5073576868
Plan sponsor’s address 1273 W. DERRYNANE STREET, LE CENTER, MN, 56057

Signature of
Role Plan administrator
Date 2013-06-18
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-18
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature
GENESIS 401(K) PLAN AND TRUST 2011 410371070 2012-07-13 GENESIS 106
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-01-01
Business code 115110
Sponsor’s telephone number 5073576868
Plan sponsor’s address 1273 W. DERRYNANE STREET, LE CENTER, MN, 56057

Plan administrator’s name and address
Administrator’s EIN 410371070
Plan administrator’s name GENESIS
Plan administrator’s address 1273 W. DERRYNANE STREET, LE CENTER, MN, 56057
Administrator’s telephone number 5073576868

Signature of
Role Plan administrator
Date 2012-07-13
Name of individual signing CHANTEL BARNETT
Valid signature Filed with authorized/valid electronic signature

Aplicant

Name Role Address
Laura A Valle Aplicant 1601 6th ST SW, WILLMAR, MN 56201

Filing

Filing Name Filing date
Original Filing - Assumed Name (Business Name: GENESIS) 2023-02-03

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 26 Sep 2024

Sources: Minnesota's Official State Website

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