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  5. Elements, LLC

Elements, LLC

Contents

Company Details

Name: Elements, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 21 Jul 2005 (19 years ago)
Entity Number: 95247
ZIP code: 99709
County: Fairbanks North Star
Place of Formation: ALASKA
Address: 1442 FARMERS LP, FAIRBANKS, AK 99709
Mailing Address: PO BOX 84001, FAIRBANKS, AK 99708

Officers

Name Role
Tina Baker Member
TINA BAKER Registered Agent

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
ELEMENTS PROFIT SHARING PLAN 2023 203458181 2024-04-03 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Sponsor ELEMENTS, LLC
Business code 812112
Sponsor’s telephone number 9073787500
Plan sponsor’s address 1157 DEBRA AVE., FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2024-04-03
Name of individual signing MS. TINA BAKER
ELEMENTS PROFIT SHARING PLAN 2022 203485181 2023-04-19 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Sponsor ELEMENTS, LLC
Business code 812112
Sponsor’s telephone number 9073787500
Plan sponsor’s address 1157 DEBRA AVENUE, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2023-04-19
Name of individual signing MS. TINA BAKER
ELEMENTS LLC MEDOVA LIFESTYLE HEALTH PLAN 2021 203485181 2024-07-12 0
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-07-01
Sponsor ELEMENTS LLC
Business code 812112
Sponsor’s telephone number 9074568877
Plan sponsor’s address 1157 DEBORAH AVE, FAIRBANKS, AK, 997093819

Plan administrator’s name and address
Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT INC
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of
Role Plan administrator
Date 2024-07-12
Name of individual signing ROBERT MOORE
ELEMENTS PROFIT SHARING PLAN 2021 203485181 2022-03-16 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Sponsor ELEMENTS, LLC
Business code 812112
Sponsor’s telephone number 9073787500
Plan sponsor’s address 1157 DEBRA AVENUE, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2022-03-16
Name of individual signing MS. TINA BAKER
ELEMENTS PROFIT SHARING PLAN 2020 203485181 2021-06-09 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Sponsor ELEMENTS, LLC
Business code 812112
Sponsor’s telephone number 9073787500
Plan sponsor’s address 1157 DEBRA AVENUE, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2021-06-09
Name of individual signing MS. TINA BAKER
ELEMENTS LLC MEDOVA LIFESTYLE HEALTH PLAN 2020 203485181 2022-05-10 8
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-08-01
Sponsor ELEMENTS LLC
Business code 812112
Sponsor’s telephone number 9074568877
Plan sponsor’s address 1157 DEBORAH AVE, FAIRBANKS, AK, 997093819

Plan administrator’s name and address
Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT INC
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of
Role Plan administrator
Date 2022-04-25
Name of individual signing ROBERT MOORE
ELEMENTS PROFIT SHARING PLAN 2019 203485181 2020-05-06 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Sponsor ELEMENTS, LLC
Business code 812112
Sponsor’s telephone number 9073787500
Plan sponsor’s address 1157 DEBRA AVENUE, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2020-05-05
Name of individual signing TINA BAKER
Role Employer/plan sponsor
Date 2020-05-05
Name of individual signing TINA BAKER
ELEMENTS PROFIT SHARING PLAN 2018 203485181 2019-04-12 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Sponsor ELEMENTS, LLC
Business code 812112
Sponsor’s telephone number 9073787500
Plan sponsor’s address 1157 DEBRA AVENUE, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2019-04-12
Name of individual signing TINA BAKER
Role Employer/plan sponsor
Date 2019-04-12
Name of individual signing TINA BAKER
ELEMENTS PROFIT SHARING PLAN 2017 203485181 2018-05-06 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Sponsor ELEMENTS, LLC
Business code 812112
Sponsor’s telephone number 9073787500
Plan sponsor’s address 1157 DEBRA AVENUE, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2018-05-02
Name of individual signing TINA BAKER
Role Employer/plan sponsor
Date 2018-05-02
Name of individual signing TINA BAKER
ELEMENTS PROFIT SHARING PLAN 2016 203485181 2017-05-11 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Sponsor ELEMENTS, LLC
Business code 812112
Sponsor’s telephone number 9073787500
Plan sponsor’s address 1157 DEBRA AVENUE, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2017-05-11
Name of individual signing TINA BAKER
Role Employer/plan sponsor
Date 2017-05-11
Name of individual signing TINA BAKER

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Shop Owner 143404 Active 2019-02-28 - 2025-08-31 -
Shop Owner 145029 Active 2019-03-29 - 2025-08-31 -

Date of last update: 11 Jan 2025

Sources: State of Alaska - Department of Commerce, Community, and Economic Development

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