NORTHLAND CORPORATION CBS BENEFIT PLAN
|
2023
|
610623284
|
2024-12-30
|
NORTHLAND CORPORATION
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-04-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022221441
|
Plan sponsor’s
address |
2600 HIGHWAY 146, LA GRANGE, KY, 40031
|
Plan administrator’s name and address
Administrator’s EIN |
846429706 |
Plan administrator’s name |
JOSEPH HSU |
Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5026954700 |
Signature of
Role |
Plan administrator |
Date |
2024-12-30 |
Name of individual signing |
JOSEPH HSU |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION CBS BENEFIT PLAN
|
2022
|
610623284
|
2023-12-27
|
NORTHLAND CORPORATION
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-04-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022221441
|
Plan sponsor’s
address |
2600 HIGHWAY 146, LA GRANGE, KY, 40031
|
Plan administrator’s name and address
Administrator’s EIN |
846429706 |
Plan administrator’s name |
SHAWNA BURTON |
Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5026954700 |
Signature of
Role |
Plan administrator |
Date |
2023-12-27 |
Name of individual signing |
SHAWNA BURTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2021
|
610623284
|
2022-05-02
|
NORTHLAND CORPORATION
|
43
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022222517
|
Plan sponsor’s
address |
P. O. BOX 265, LAGRANGE, KY, 40031
|
Signature of
Role |
Plan administrator |
Date |
2022-05-02 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION CBS BENEFIT PLAN
|
2021
|
610623284
|
2022-12-29
|
NORTHLAND CORPORATION
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-04-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022221441
|
Plan sponsor’s
address |
2600 HIGHWAY 146, LA GRANGE, KY, 40031
|
Plan administrator’s name and address
Administrator’s EIN |
846429706 |
Plan administrator’s name |
SHAWNA BURTON |
Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5026954700 |
Signature of
Role |
Plan administrator |
Date |
2022-12-29 |
Name of individual signing |
SHAWNA BURTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION CBS BENEFIT PLAN
|
2020
|
610623284
|
2021-12-14
|
NORTHLAND CORPORATION
|
22
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-04-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022221441
|
Plan sponsor’s
address |
2600 HIGHWAY 146, LA GRANGE, KY, 40031
|
Plan administrator’s name and address
Administrator’s EIN |
846429706 |
Plan administrator’s name |
SHAWNA BURTON |
Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5026954700 |
Signature of
Role |
Plan administrator |
Date |
2021-12-14 |
Name of individual signing |
SHAWNA BURTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2020
|
610623284
|
2021-04-07
|
NORTHLAND CORPORATION
|
53
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022222517
|
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031
|
Signature of
Role |
Plan administrator |
Date |
2021-04-07 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2019
|
610623284
|
2020-05-05
|
NORTHLAND CORPORATION
|
66
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022222517
|
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031
|
Signature of
Role |
Plan administrator |
Date |
2020-05-05 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION CBS BENEFIT PLAN
|
2019
|
610623284
|
2020-12-23
|
NORTHLAND CORPORATION
|
22
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2020-04-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022221441
|
Plan sponsor’s
address |
2600 HIGHWAY 146, LA GRANGE, KY, 40031
|
Plan administrator’s name and address
Administrator’s EIN |
846429706 |
Plan administrator’s name |
KELLY WOLF |
Plan administrator’s
address |
464 CHENAULT RD, FRANKFORT, KY, 40601 |
Administrator’s telephone number |
5026954700 |
Signature of
Role |
Plan administrator |
Date |
2020-12-23 |
Name of individual signing |
KELLY WOLF |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2018
|
610623284
|
2019-04-15
|
NORTHLAND CORPORATION
|
73
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022222517
|
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031
|
Signature of
Role |
Plan administrator |
Date |
2019-04-15 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2017
|
610623284
|
2018-06-11
|
NORTHLAND CORPORATION
|
75
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
1994-01-01
|
Business code |
423300
|
Sponsor’s telephone number |
5022222517
|
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031
|
Signature of
Role |
Plan administrator |
Date |
2018-06-11 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2016
|
610623284
|
2017-10-12
|
NORTHLAND CORPORATION
|
99
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/12/20171012084851P030005948921001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
1994-01-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222517 |
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Signature of
Role |
Plan administrator |
Date |
2017-10-12 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2015
|
610623284
|
2016-06-24
|
NORTHLAND CORPORATION
|
103
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/06/24/20160624143521P030005668893001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
1994-01-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222517 |
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Signature of
Role |
Plan administrator |
Date |
2016-06-24 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2014
|
610623284
|
2015-05-14
|
NORTHLAND CORPORATION
|
79
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/05/14/20150514122944P030303844657001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
1994-01-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222517 |
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Signature of
Role |
Plan administrator |
Date |
2015-05-14 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH PROTECTION PLAN FOR EMPLOYEES OF NORTHLAND CORPORATION
|
2013
|
610623284
|
2015-10-22
|
NORTHLAND CORPORATION
|
36
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/22/20151022173431P030041524893001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2005-04-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222545 |
Plan sponsor’s mailing address |
PO BOX 265, LA GRANGE, KY, 40031 |
Plan sponsor’s
address |
HIGHWAY 146 EAST, LA GRANGE, KY, 40031 |
Number of participants as of the end of the plan year
Active participants |
37 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-10-22 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH PROTECTION PLAN FOR EMPLOYEES OF NORTHLAND CORPORATION
|
2013
|
610623284
|
2015-01-19
|
NORTHLAND CORPORATION
|
36
|
|
Three-digit plan number (PN) |
501 |
Effective date of plan |
2005-04-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222545 |
Plan sponsor’s mailing address |
PO BOX 265, LAGRANGE, KY, 40031 |
Plan sponsor’s
address |
HIGHWAY 146 EAST, LAGRANGE, KY, 40031 |
Number of participants as of the end of the plan year
Active participants |
37 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-01-19 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-19 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2015-01-14 |
Name of individual signing |
BILLIE ROTERT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2013
|
610623284
|
2014-07-07
|
NORTHLAND CORPORATION
|
75
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/07/20140707101835P040009280095001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
1994-01-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222517 |
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Signature of
Role |
Plan administrator |
Date |
2014-07-07 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH PROTECTION PLAN FOR EES OF NORTHLAND CORP
|
2012
|
610623284
|
2014-01-07
|
NORTHLAND CORPORATION
|
38
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/01/07/20140107064159P030020576855001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2005-04-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222545 |
Plan sponsor’s mailing address |
PO BOX 265, LAGRANGE, KY, 40031 |
Plan sponsor’s
address |
2600 HIGHWAY 146 EAST, LAGRANGE, KY, 40031 |
Number of participants as of the end of the plan year
Active participants |
37 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-01-06 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-01-06 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2014-01-07 |
Name of individual signing |
JESSICA CATER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2012
|
610623284
|
2013-06-06
|
NORTHLAND CORPORATION
|
66
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/06/06/20130606121602P040086739749001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
1994-01-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222517 |
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Signature of
Role |
Plan administrator |
Date |
2013-06-06 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH PROTECTION PLAN FOR EMPLOYEES OF NORTHLAND CORP.
|
2011
|
610623284
|
2013-01-17
|
NORTHLAND CORPORATION
|
39
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/01/17/20130117133902P030015950565001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2005-04-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222545 |
Plan sponsor’s mailing address |
PO BOX 465, LAGRANGE, KY, 40031 |
Plan sponsor’s
address |
HIGHWAY 146 EAST, LAGRANGE, KY, 40031 |
Plan administrator’s name and address
Administrator’s EIN |
610623284 |
Plan administrator’s name |
NORTHLAND CORPORATION |
Plan administrator’s
address |
PO BOX 465, LAGRANGE, KY, 40031 |
Administrator’s telephone number |
5022222545 |
Number of participants as of the end of the plan year
Active participants |
40 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-01-17 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-01-17 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2013-01-17 |
Name of individual signing |
BILLIE ROTERT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2011
|
610623284
|
2012-04-25
|
NORTHLAND CORPORATION
|
60
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/04/25/20120425080206P040000169378001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
1994-01-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222517 |
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Plan administrator’s name and address
Administrator’s EIN |
610623284 |
Plan administrator’s name |
NORTHLAND CORPORATION |
Plan administrator’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Administrator’s telephone number |
5022222517 |
Signature of
Role |
Plan administrator |
Date |
2012-04-25 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH PROTECTION PLAN FOR EES OF NORTHLAND CORP.
|
2010
|
610623284
|
2012-01-11
|
NORTHLAND CORPORATION
|
41
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/01/11/20120111131113P040015497873001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2005-04-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222545 |
Plan sponsor’s mailing address |
PO BOX 265, HIGHWAY 146 EAST, LAGRANGE, KY, 40031 |
Plan sponsor’s
address |
PO BOX 265, HIGHWAY 146 EAST, LAGRANGE, KY, 40031 |
Plan administrator’s name and address
Administrator’s EIN |
610623284 |
Plan administrator’s name |
NORTHLAND CORPORATION |
Plan administrator’s
address |
PO BOX 265, HIGHWAY 146 EAST, LAGRANGE, KY, 40031 |
Administrator’s telephone number |
5022222545 |
Number of participants as of the end of the plan year
Active participants |
43 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-01-10 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-01-10 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2012-01-09 |
Name of individual signing |
BILLIE ROTERT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2010
|
610623284
|
2011-02-24
|
NORTHLAND CORPORATION
|
66
|
|
Three-digit plan number (PN) |
001 |
Effective date of plan |
1994-01-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222517 |
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Plan administrator’s name and address
Administrator’s EIN |
610623284 |
Plan administrator’s name |
NORTHLAND CORPORATION |
Plan administrator’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Administrator’s telephone number |
5022222517 |
Signature of
Role |
Plan administrator |
Date |
2011-02-24 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with incorrect/unrecognized electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2010
|
610623284
|
2011-02-24
|
NORTHLAND CORPORATION
|
66
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/02/24/20110224150656P030072877648001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
1994-01-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222517 |
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Plan administrator’s name and address
Administrator’s EIN |
610623284 |
Plan administrator’s name |
NORTHLAND CORPORATION |
Plan administrator’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Administrator’s telephone number |
5022222517 |
Signature of
Role |
Plan administrator |
Date |
2011-02-24 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION
|
2009
|
610623284
|
2011-01-25
|
NORTHLAND CORPORATION
|
49
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/25/20110125102108P040003068514001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2005-04-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222545 |
Plan sponsor’s mailing address |
PO BOX 265, HIGHWAY 146 EAST, LAGRANGE, KY, 40031 |
Plan sponsor’s
address |
PO BOX 265, HIGHWAY 146 EAST, LAGRANGE, KY, 40031 |
Plan administrator’s name and address
Administrator’s EIN |
610623284 |
Plan administrator’s name |
NORTHLAND CORPORATION |
Plan administrator’s
address |
PO BOX 265, HIGHWAY 146 EAST, LAGRANGE, KY, 40031 |
Administrator’s telephone number |
5022222545 |
Number of participants as of the end of the plan year
Active participants |
41 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-01-25 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-25 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
DFE |
Date |
2011-01-13 |
Name of individual signing |
BILLIE ROTERT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NORTHLAND CORPORATION 401K PLAN
|
2009
|
610623284
|
2010-07-02
|
NORTHLAND CORPORATION
|
78
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/02/20100702144707P040351466065001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
1994-01-01 |
Business code |
423300 |
Sponsor’s telephone number |
5022222517 |
Plan sponsor’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Plan administrator’s name and address
Administrator’s EIN |
610623284 |
Plan administrator’s name |
NORTHLAND CORPORATION |
Plan administrator’s
address |
P. O. BOX 265, LA GRANGE, KY, 40031 |
Administrator’s telephone number |
5022222517 |
Signature of
Role |
Plan administrator |
Date |
2010-07-02 |
Name of individual signing |
MARLENE HUGHES |
Valid signature |
Filed with authorized/valid electronic signature |
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