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  5. MINI DATA FORMS, INC.

MINI DATA FORMS, INC.

Company Details

Name: MINI DATA FORMS, INC.
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Corporation
Status: Inactive
Standing: Good
File Date: 23 May 1983 (42 years ago)
Organization Date: 23 May 1983 (42 years ago)
Last Annual Report: 26 Jun 2008 (17 years ago)
Organization Number: 0178170
ZIP code: 40511
Primary County: Fayette
Principal Office: 2060 BUCK LANE, LEXINGTON, KY 40511
Place of Formation: KENTUCKY
Authorized Shares: 1000

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MINI DATA FORMS RETIREMENT PLAN 2014 621366750 2015-07-21 MINI DATA FORMS, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 323100
Sponsor’s telephone number 7049625467
Plan sponsor’s address P O BOX 13490, LEXINGTON, KY, 40583

Signature of
Role Plan administrator
Date 2015-07-21
Name of individual signing CYNTHIA TAYLOR
Valid signature Filed with authorized/valid electronic signature
MINI DATA FORMS RETIREMENT PLAN 2014 621366750 2015-12-29 MINI DATA FORMS, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 323100
Sponsor’s telephone number 7049625467
Plan sponsor’s address P O BOX 13490, LEXINGTON, KY, 40583

Signature of
Role Plan administrator
Date 2015-12-29
Name of individual signing CYNTHIA TAYLOR
Valid signature Filed with authorized/valid electronic signature
MINI DATA FORMS RETIREMENT PLAN 2013 621366750 2014-07-21 MINI DATA FORMS, INC. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 323100
Sponsor’s telephone number 7049625467
Plan sponsor’s address P O BOX 13490, LEXINGTON, KY, 40583

Signature of
Role Plan administrator
Date 2014-07-21
Name of individual signing CYNTHIA TAYLOR
Valid signature Filed with authorized/valid electronic signature
MINI DATA FORMS RETIREMENT PLAN 2012 621366750 2013-06-28 MINI DATA FORMS, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 323100
Sponsor’s telephone number 7049625467
Plan sponsor’s address P O BOX 13490, LEXINGTON, KY, 40583

Signature of
Role Plan administrator
Date 2013-06-28
Name of individual signing CYNTHIA TAYLOR
Valid signature Filed with authorized/valid electronic signature
MINI DATA FORMS RETIREMENT PLAN 2011 621366750 2012-07-19 MINI DATA FORMS, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 323100
Sponsor’s telephone number 7049625467
Plan sponsor’s address P O BOX 13490, LEXINGTON, KY, 40583

Plan administrator’s name and address
Administrator’s EIN 621366750
Plan administrator’s name MINI DATA FORMS, INC.
Plan administrator’s address P O BOX 13490, LEXINGTON, KY, 40583
Administrator’s telephone number 7049625467

Signature of
Role Plan administrator
Date 2012-07-19
Name of individual signing CYNTHIA TAYLOR
Valid signature Filed with authorized/valid electronic signature
MINI DATA FORMS RETIREMENT PLAN 2010 611028804 2011-07-22 MINI DATA FORMS, INC. 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 323100
Sponsor’s telephone number 7049625467
Plan sponsor’s address P O BOX 13490, LEXINGTON, KY, 40583

Plan administrator’s name and address
Administrator’s EIN 611028804
Plan administrator’s name MINI DATA FORMS, INC.
Plan administrator’s address P O BOX 13490, LEXINGTON, KY, 40583
Administrator’s telephone number 7049625467

Signature of
Role Plan administrator
Date 2011-07-22
Name of individual signing CYNTHIA TAYLOR
Valid signature Filed with authorized/valid electronic signature
MINI DATA FORMS RETIREMENT PLAN 2009 611028804 2010-07-23 MINI DATA FORMS, INC. 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 323100
Sponsor’s telephone number 8592317772
Plan sponsor’s address 2060 BUCK LANE, LEXINGTON, KY, 40511

Plan administrator’s name and address
Administrator’s EIN 611028804
Plan administrator’s name MINI DATA FORMS, INC.
Plan administrator’s address 2060 BUCK LANE, LEXINGTON, KY, 40511
Administrator’s telephone number 8592317772

Signature of
Role Plan administrator
Date 2010-07-23
Name of individual signing CYNTHIA TAYLOR
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
DONALD VAN CLEVE Registered Agent

President

Name Role
DARREN VANCLEVE President

Signature

Name Role
DARREN C VAN CLEVE Signature

Director

Name Role
DONALD VAN CLEVE Director

Incorporator

Name Role
DONALD VAN CLEVE Incorporator

Assumed Names

Name Status Expiration Date
COMPATIBLE FORMS & CHECKS Inactive 2003-07-15

Filings

Name File Date
Dissolution 2008-11-26
Annual Report 2008-06-26
Annual Report 2007-01-19
Annual Report 2006-08-16
Annual Report 2005-06-09
Annual Report 2003-08-25
Annual Report 2002-07-03
Annual Report 2001-09-12
Annual Report 2000-07-07
Annual Report 1999-07-21

Related by officers

DONALD VAN CLEVE

BERRILL GRAPHICS, INC.

Related by address

2060 BUCK LANE, LEXINGTON, KY 40511

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Date of last update: 14 Jan 2025

Sources: Kentucky Secretary of State

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