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  5. PHS, Inc.

PHS, Inc.

Company Details

Name: PHS, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 08 Aug 1994 (30 years ago)
Company Number: 88d13f6f-b7d4-e011-a886-001ec94ffe7f
File Number: 8I-625
Registered Office Address: 56332-160th Street, Wells, MN 56097, USA
Principal Executive Office Address: 4900 Hwy 169 N #324, New Hope, MN 55428, USA
ZIP code: 56097
County: Faribault County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PHS INC 401K PLAN 2019 411790831 2020-11-22 PHS INC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Signature of
Role Plan administrator
Date 2020-11-22
Name of individual signing COURTNEY JENSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-11-22
Name of individual signing COURTNEY JENSEN
Valid signature Filed with authorized/valid electronic signature
PHS INC 401K PLAN 2019 411790831 2020-07-17 PHS INC 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Signature of
Role Plan administrator
Date 2020-07-17
Name of individual signing COURTNEY JENSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-17
Name of individual signing COURTNEY JENSEN
Valid signature Filed with authorized/valid electronic signature
PHS INC 401K PLAN 2018 411790831 2019-04-16 PHS INC 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Signature of
Role Plan administrator
Date 2019-04-16
Name of individual signing COURTNEY JENSEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-04-16
Name of individual signing COURTNEY JENSEN
Valid signature Filed with authorized/valid electronic signature
PHS INC 401K PLAN 2017 411790831 2018-04-24 PHS INC 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Signature of
Role Plan administrator
Date 2018-04-24
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-24
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
PHS INC 401K PLAN 2016 411790831 2017-05-16 PHS INC 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Signature of
Role Plan administrator
Date 2017-05-16
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-16
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
PHS INC 401K PLAN 2015 411790831 2016-06-01 PHS INC 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Signature of
Role Plan administrator
Date 2016-06-01
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-01
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
PHS INC 401K PLAN 2014 411790831 2015-07-15 PHS INC 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Signature of
Role Plan administrator
Date 2015-07-15
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-15
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
PHS INC 401K PLAN 2013 411790831 2014-07-24 PHS INC 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Signature of
Role Plan administrator
Date 2014-07-24
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-24
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
PHS INC 401K PLAN 2012 411790831 2013-06-04 PHS INC 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Signature of
Role Plan administrator
Date 2013-06-04
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-04
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
PHS INC 401K PLAN 2011 411790831 2012-07-02 PHS INC 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-07-01
Business code 621610
Sponsor’s telephone number 7635368128
Plan sponsor’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428

Plan administrator’s name and address
Administrator’s EIN 411790831
Plan administrator’s name PHS INC
Plan administrator’s address 4900 HIGHWAY 169, SUITE 324, NEW HOPE, MN, 55428
Administrator’s telephone number 7635368128

Signature of
Role Plan administrator
Date 2012-06-25
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-25
Name of individual signing MIKE POTACZEK
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
MICHAEL A POTACZEK Chief Executive Officer 4900 Hwy 169 N #324, New Hope, MN 55428, USA

Agent

Name Role
Duane Johnson Agent

Filing

Filing Name Filing date
Intent to Dissolve - Business Corporation (Domestic) 2020-12-21
Dissolution - Business Corporation (Domestic) 2020-12-21
Registered Office and/or Agent - Business Corporation (Domestic) 1996-09-26
Original Filing - Business Corporation (Domestic) 1994-08-08
Business Corporation (Domestic) Business Name (Business Name: PHS, Inc.) 1994-08-08

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Related by address

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Date of last update: 03 Oct 2024

Sources: Minnesota's Official State Website

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