| Name: | Blue Earth Family Dental, Inc |
| Jurisdiction: | Minnesota |
| Legal type: | Business Corporation (Domestic) |
| Status: | Active / In Good Standing |
| Date formed: | 16 May 2014 (11 years ago) |
| Company Number: | bfcf3728-73df-e311-a9cc-001ec94ffe7f |
| File Number: | 761011500038 |
| Registered Office Address: | 17860 594th Ave, Mankato, MN 56001, USA |
| Principal Executive Office Address: | 519 S GALBRAITH ST, BLUE EARTH, MN 56013–2155, USA |
| ZIP code: | 56001 |
| County: | Blue Earth County |
| Place of Formation: | Minnesota |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLUE EARTH FAMILY DENTAL 401(K) PLAN | 2023 | 471046182 | 2024-10-11 | BLUE EARTH FAMILY DENTAL, INC. | 11 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-11 |
| Name of individual signing | SAMANTHA SEYS |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-10-11 |
| Name of individual signing | SAMANTHA SEYS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 5075263111 |
| Plan sponsor’s address | 519 S. GALBRAITH STREET, BLUE EARTH, MN, 56013 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-13 |
| Name of individual signing | SAMANTHA SEYS |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-10-13 |
| Name of individual signing | SAMANTHA SEYS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Samantha K Seys | Chief Executive Officer | 519 S GALBRAITH ST, BLUE EARTH, MN 56013–2155, USA |
| Name | Role |
|---|---|
| Samantha Seys | Agent |
| Filing Name | Filing date |
|---|---|
| Original Filing - Business Corporation (Domestic) (Business Name: Blue Earth Family Dental, Inc) | 2014-05-16 |
Date of last update: 30 Sep 2024
Sources: Minnesota's Official State Website
