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  5. Elders Home, Inc.

Elders Home, Inc.

Company Details

Name: Elders Home, Inc.
Jurisdiction: Minnesota
Legal type: Nonprofit Corporation (Domestic)
Status: Inactive
Date formed: 20 Jan 1959 (66 years ago)
Company Number: cad6d642-aed4-e011-a886-001ec94ffe7f
File Number: C-971
Registered Office Address: 215 South Tousley Avenue, New York Mills, MN 56567, USA
ZIP code: 56567
County: Otter Tail County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ELDERS HOME INC. TAX DEFERRED ANNUITY PLAN 2017 410837822 2018-06-07 ELDERS HOME INC 83
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address P.O. BOX 188, NEW YORK MILLS, MN, 565670188

Signature of
Role Plan administrator
Date 2018-06-07
Name of individual signing LORI NELSON
Valid signature Filed with authorized/valid electronic signature
ELDERS HOME INC. EMPLOYEES PENSION PLAN 2017 410837822 2018-06-07 ELDERS HOME INC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address P.O. BOX 188, NEW YORK MILLS, MN, 565670188

Signature of
Role Plan administrator
Date 2018-06-07
Name of individual signing LORI NELSON
Valid signature Filed with authorized/valid electronic signature
ELDERS HOME INC. EMPLOYEES PENSION PLAN 2017 410837822 2018-06-06 ELDERS HOME INC 65
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address P.O. BOX 188, NEW YORK MILLS, MN, 565670188

Signature of
Role Plan administrator
Date 2018-06-06
Name of individual signing LORI NELSON
Valid signature Filed with authorized/valid electronic signature
ELDERS HOME INC. EMPLOYEES PENSION PLAN 2016 410837822 2017-07-12 ELDERS HOME INC 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address P.O. BOX 188, NEW YORK MILLS, MN, 565670188

Signature of
Role Plan administrator
Date 2017-07-12
Name of individual signing LINDA SEBENALER
Valid signature Filed with authorized/valid electronic signature
ELDERS HOME INC. TAX DEFERRED ANNUITY PLAN 2016 410837822 2017-07-12 ELDERS HOME INC 85
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address 215 SOUTH TOUSLEY AVENUE, NEW YORK MILLS, MN, 56567

Signature of
Role Plan administrator
Date 2017-07-12
Name of individual signing LINDA SEBENALER
Valid signature Filed with authorized/valid electronic signature
ELDERS HOME INC. EMPLOYEES PENSION PLAN 2015 410837822 2016-10-06 ELDERS HOME INC. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address P.O. BOX 188, NEW YORK MILLS, MN, 565670188

Signature of
Role Plan administrator
Date 2016-10-06
Name of individual signing LINDA SEBENALER
Valid signature Filed with authorized/valid electronic signature
ELDERS HOME INC. TAX DEFERRED ANNUITY PLAN 2015 410837822 2016-10-06 ELDERS HOME INC. 80
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address P.O. BOX 188, NEW YORK MILLS, MN, 565670188

Signature of
Role Plan administrator
Date 2016-10-06
Name of individual signing LINDA SEBENALER
Valid signature Filed with authorized/valid electronic signature
ELDERS HOME INC. EMPLOYEES PENSION PLAN 2014 410837822 2015-10-09 ELDERS HOME INC. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address P.O. BOX 188, NEW YORK MILLS, MN, 565670188

Signature of
Role Plan administrator
Date 2015-10-09
Name of individual signing LORI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-09
Name of individual signing CALVIN ANDERSON
Valid signature Filed with authorized/valid electronic signature
ELDERS HOME INC. TAX DEFERRED ANNUITY PLAN 2014 410837822 2015-10-09 ELDERS HOME INC. 81
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address P.O. BOX 188, NEW YORK MILLS, MN, 565670188

Signature of
Role Plan administrator
Date 2015-10-09
Name of individual signing LORI NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-09
Name of individual signing CALVIN ANDERSON
Valid signature Filed with authorized/valid electronic signature
ELDERS HOME INC. EMPLOYEES PENSION PLAN 2014 410837822 2015-07-29 ELDERS HOME INC. 47
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 623000
Sponsor’s telephone number 2183852005
Plan sponsor’s address P.O. BOX 188, NEW YORK MILLS, MN, 565670188

Signature of
Role Plan administrator
Date 2015-07-29
Name of individual signing BRENDA BOYNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-29
Name of individual signing CALVIN ANDERSON
Valid signature Filed with authorized/valid electronic signature

President

Name Role Address
Diego Martinez President P.O. Box 188, New York Mills, MN 56567–0188, USA

Filing

Filing Name Filing date
Intent to Dissolve - Nonprofit Corporation (Domestic) 2019-01-30
Annual Reinstatement - Nonprofit Corporation (Domestic) 2018-03-20
Involuntary Dissolution - Nonprofit Corporation (Domestic) 2018-03-08
Amendment - Nonprofit Corporation (Domestic)Restated Articles 2018-01-23
Amendment - Nonprofit Corporation (Domestic) 1962-06-19
Nonprofit Corporation (Domestic) Business Name (Business Name: Elders Home, Inc.) 1959-01-20
Original Filing - Nonprofit Corporation (Domestic) 1959-01-20

Related by officers

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Related by address

215 South Tousley Avenue, New York Mills, MN 56567, USA

Elders Home Foundation, Inc.

Date of last update: 25 Sep 2024

Sources: Minnesota's Official State Website

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