HIGH PLAINS FOOD STORE, INC. 401K PLAN
|
2015
|
841093597
|
2016-09-26
|
HIGH PLAINS FOOD STORE, INC.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
7202749681
|
Plan sponsor’s
address |
403 ARAPAHOE ST., P.O. BOX 645, KIOWA, CO, 80117
|
Signature of
Role |
Plan administrator |
Date |
2016-09-26 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-09-26 |
Name of individual signing |
MONA SCHANTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HIGH PLAINS FOOD STORE, INC. 401K PLAN
|
2015
|
841093597
|
2016-07-25
|
HIGH PLAINS FOOD STORE, INC.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
7202749681
|
Plan sponsor’s
address |
403 ARAPAHOE ST., P.O. BOX 645, KIOWA, CO, 80117
|
Signature of
Role |
Plan administrator |
Date |
2016-07-25 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-25 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HIGH PLAINS FOOD STORE, INC. 401K PLAN
|
2014
|
841093597
|
2016-07-25
|
HIGH PLAINS FOOD STORE, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
7202749681
|
Plan sponsor’s
address |
403 ARAPAHOE ST., P.O. BOX 645, KIOWA, CO, 80117
|
Signature of
Role |
Plan administrator |
Date |
2016-07-25 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-25 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HIGH PLAINS FOOD STORE, INC. 401K PLAN
|
2013
|
841093597
|
2016-07-25
|
HIGH PLAINS FOOD STORE, INC.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
7202749681
|
Plan sponsor’s
address |
430 ARAPAHOE ST., P.O. BOX 645, KIOWA, CO, 80117
|
Signature of
Role |
Plan administrator |
Date |
2016-07-25 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-25 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HIGH PLAINS FOOD STORE, INC. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2013
|
841093597
|
2014-02-21
|
HIGH PLAINS FOOD STORE, INC.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-01-01
|
Business code |
445120
|
Sponsor’s telephone number |
3036212565
|
Plan sponsor’s
address |
P.O. BOX 645, KIOWA, CO, 80117
|
Plan administrator’s name and address
Administrator’s EIN |
841093597 |
Plan administrator’s name |
HIGH PLAINS FOOD STORE, INC. |
Plan administrator’s
address |
P.O. BOX 645, KIOWA, CO, 80117 |
Administrator’s telephone number |
3036212565 |
Signature of
Role |
Plan administrator |
Date |
2014-02-21 |
Name of individual signing |
STEVE SCHANTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HIGH PLAINS FOOD STORE, INC. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2012
|
841093597
|
2013-07-12
|
HIGH PLAINS FOOD STORE, INC.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-01-01
|
Business code |
445120
|
Sponsor’s telephone number |
3036212565
|
Plan sponsor’s
address |
P.O. BOX 645, KIOWA, CO, 80117
|
Plan administrator’s name and address
Administrator’s EIN |
841093597 |
Plan administrator’s name |
HIGH PLAINS FOOD STORE, INC. |
Plan administrator’s
address |
P.O. BOX 645, KIOWA, CO, 80117 |
Administrator’s telephone number |
3036212565 |
Signature of
Role |
Plan administrator |
Date |
2013-07-12 |
Name of individual signing |
STEVE SCHANTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HIGH PLAINS FOOD STORE, INC. 401K PLAN
|
2012
|
841093597
|
2013-10-11
|
HIGH PLAINS FOOD STORE, INC.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
7202749681
|
Plan sponsor’s
address |
430 ARAPAHOE ST., P.O. BOX 645, KIOWA, CO, 80117
|
Signature of
Role |
Plan administrator |
Date |
2013-10-11 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-11 |
Name of individual signing |
STEVAN C ZAHNOW |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HIGH PLAINS FOOD STORE, INC. 401K PLAN
|
2011
|
841093597
|
2012-07-11
|
HIGH PLAINS FOOD STORE, INC.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
7202749681
|
Plan sponsor’s
address |
430 ARAPAHOE ST., P.O. BOX 645, KIOWA, CO, 80117
|
Plan administrator’s name and address
Administrator’s EIN |
841093597 |
Plan administrator’s name |
HIGH PLAINS FOOD STORE, INC. |
Plan administrator’s
address |
430 ARAPAHOE ST., P.O. BOX 645, KIOWA, CO, 80117 |
Administrator’s telephone number |
7202749681 |
Signature of
Role |
Plan administrator |
Date |
2012-07-11 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-07-11 |
Name of individual signing |
STEVEN SCHANTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HIGH PLAINS FOOD STORE, INC. DEFINED BENEFIT PENSION PLAN AND TRUST
|
2011
|
841093597
|
2012-10-09
|
HIGH PLAINS FOOD STORE, INC.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2007-01-01
|
Business code |
445120
|
Sponsor’s telephone number |
3036212565
|
Plan sponsor’s
address |
P.O. BOX 645, KIOWA, CO, 80117
|
Plan administrator’s name and address
Administrator’s EIN |
841093597 |
Plan administrator’s name |
HIGH PLAINS FOOD STORE, INC. |
Plan administrator’s
address |
P.O. BOX 645, KIOWA, CO, 80117 |
Administrator’s telephone number |
3036212565 |
Signature of
Role |
Plan administrator |
Date |
2012-10-09 |
Name of individual signing |
STEVE SCHANTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HIGH PLAINS FOOD STORE, INC. 401K PLAN
|
2010
|
841093597
|
2011-07-07
|
HIGH PLAINS FOOD STORE, INC.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
541990
|
Sponsor’s telephone number |
7202749681
|
Plan sponsor’s
address |
430 ARAPAHOE ST., P.O. BOX 645, KIOWA, CO, 80117
|
Plan administrator’s name and address
Administrator’s EIN |
841093597 |
Plan administrator’s name |
HIGH PLAINS FOOD STORE, INC. |
Plan administrator’s
address |
430 ARAPAHOE ST., P.O. BOX 645, KIOWA, CO, 80117 |
Administrator’s telephone number |
7202749681 |
Signature of
Role |
Plan administrator |
Date |
2011-07-07 |
Name of individual signing |
PAUL REDD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-07 |
Name of individual signing |
STEVE SCHANTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|