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  5. BLAINE MANOR

BLAINE MANOR

Company Details

Name: BLAINE MANOR
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Inactive-Cancelled
Date of registration: 12 Aug 2011 (13 years ago)
Entity Number: 454735
Place of Formation: IDAHO
File Number: 0000454735
ZIP code: 83333
County: Blaine County
Mailing Address: PO BOX 640 HAILEY, ID 83333

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLAINE MANOR 401K PLAN 2013 201940695 2014-01-14 BLAINE MANOR 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 623000
Sponsor’s telephone number 2087887180
Plan sponsor’s address P.O. BOX 927, HAILEY, ID, 833330927

Plan administrator’s name and address
Administrator’s EIN 201940695
Plan administrator’s name BLAINE MANOR
Plan administrator’s address P.O. BOX 927, HAILEY, ID, 833330927
Administrator’s telephone number 2087887180

Signature of
Role Plan administrator
Date 2014-01-14
Name of individual signing STEPHANIE JASKOWSKI
Valid signature Filed with authorized/valid electronic signature
BLAINE MANOR 401K PLAN 2012 201940695 2013-09-18 BLAINE MANOR 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 623000
Sponsor’s telephone number 2087887180
Plan sponsor’s address P.O. BOX 927, HAILEY, ID, 833330927

Plan administrator’s name and address
Administrator’s EIN 201940695
Plan administrator’s name BLAINE MANOR
Plan administrator’s address P.O. BOX 927, HAILEY, ID, 833330927
Administrator’s telephone number 2087887180

Signature of
Role Plan administrator
Date 2013-09-18
Name of individual signing STEPHANIE JASKOWSKI
Valid signature Filed with authorized/valid electronic signature
BLAINE MANOR 401K PLAN 2011 201940695 2012-07-11 BLAINE MANOR 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 623000
Sponsor’s telephone number 2087887180
Plan sponsor’s address P.O. BOX 927, HAILEY, ID, 833330927

Plan administrator’s name and address
Administrator’s EIN 201940695
Plan administrator’s name BLAINE MANOR
Plan administrator’s address P.O. BOX 927, HAILEY, ID, 833330927
Administrator’s telephone number 2087887180

Signature of
Role Plan administrator
Date 2012-07-11
Name of individual signing STEPHANIE JASKOWSKI
Valid signature Filed with authorized/valid electronic signature
BLAINE MANOR 401K PLAN 2010 201940695 2011-04-13 BLAINE MANOR 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 623000
Sponsor’s telephone number 2085783504
Plan sponsor’s address P.O. BOX 927, HAILEY, ID, 833330927

Plan administrator’s name and address
Administrator’s EIN 201940695
Plan administrator’s name BLAINE MANOR
Plan administrator’s address P.O. BOX 927, HAILEY, ID, 833330927
Administrator’s telephone number 2085783504

Signature of
Role Plan administrator
Date 2011-04-13
Name of individual signing STEPHANIE JASKOWSKI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-04-13
Name of individual signing STEPHANIE JASKOWSKI
Valid signature Filed with authorized/valid electronic signature
BLAINE MANOR 401K PLAN 2009 201940695 2010-05-21 BLAINE MANOR 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 623000
Sponsor’s telephone number 2085783504
Plan sponsor’s address P.O. BOX 927, HAILEY, ID, 833330927

Plan administrator’s name and address
Administrator’s EIN 201940695
Plan administrator’s name BLAINE MANOR
Plan administrator’s address P.O. BOX 927, HAILEY, ID, 833330927
Administrator’s telephone number 2085783504

Signature of
Role Plan administrator
Date 2010-05-21
Name of individual signing STEPHANIE JASKOWSKI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-05-21
Name of individual signing STEPHANIE JASKOWSKI
Valid signature Filed with authorized/valid electronic signature

Filing

Filing Name Filing Number Filing date
Cancellation of Certificate of Assumed Business Name 0000903283 2012-02-09
Initial Filing 0000454735 2011-08-12

Related by officers

No related officers

Related by address

PO BOX 640 HAILEY, ID 83333

CROY CANYON RANCH FOUNDATION, INC.

Date of last update: 26 Sep 2024

Sources: Idaho Secretary of State

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