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<br /> � Fo� SS-4 Application for fmpl�yer ldentification Number
<br /> (For use by emptoyers,cor cuations, artnershi s,Vusts,estates,chu�cltes, EIN
<br /> (Rev.December 2001) government agencies,Ind an tribal entities,certain individuals,and others.)
<br /> Department oi the 7reasury OMB N0.1545-UOU3
<br /> Intemel Revenue Servke ► See separate iestructions far each line. ► Keep a co y for your records.
<br /> 1 Legal name of entity(or individual)for whom the fIN is being requested
<br /> North�ore Meadows,LLC
<br /> �' 2 Trade name of business�f di�ferent from name on Iine 1) 3 Executor,wstee, "care of'name
<br /> �.
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<br /> i� 4a Mailing address(room,apt.,suite no. and sueet,or P.O.box) 5a Sveet address(if differen�(Do not enter a P.O, box.)
<br /> c 1150 Old Crystal Bay Road
<br /> .`C. 4b City, state,and ZIP code 5b Ciry,state,and ZIP code
<br /> o Orono,MN 55381
<br /> Q 6 County and state where principal business is located
<br /> � Hsnnepin County, Minnesotia
<br /> 7a Name of�ineipai officer,general partner,c,�rantor,owner,ar Vustot 7b SSN,ITIN,a EIN
<br /> Gregg W.Stelnhafel,Chief Manager 398-4Cr0223
<br /> 8a Type af entiky(cheek only orre bqx) ❑ Estate(SSN of deceden�
<br /> ❑Sole Fxoprietor(SSN) ' ' � Rlan adminisuator(SSPq ; �
<br /> �PartnershiP • ❑ Trust(SSN of grantor)
<br /> ❑Garparatia�►(enter form number to be flle�d) ► ❑ National Guard ❑ State./tocal gnvemment
<br /> ❑Persanaf s�vice corp. ❑ Farmers'cooperative ❑ Federal governmendmilitary
<br /> ❑Church or church-controlled organization ❑ REMIC ❑ Indian vitral govemme�rts/enteqxises
<br /> ❑Other nonprvfit organization(specify) ► Group Exemption Number(GEN) ►
<br /> ❑Other s ci ) ►
<br /> 8b If a corporation, name the state or foreign country State Foreign counVy
<br /> (if applicable)where incwporated N/A N/A
<br /> 8 Reason for applying(check only one box) ❑ Banking purpose(specify purpose) ►
<br /> �Siarted new business(specify type) ► ❑ Changed rype of organizaUon(specify new type) ►
<br /> Real Estate Devetopment ❑ Purchased going business
<br /> ❑Hired employees(Check the box and see Jine 12.) ❑ Created a Vust(specify type) ►
<br /> ❑Compltance with IRS withholding regulatians ❑ Created a pension plan(specify rype) ►
<br /> ❑Other(speci ) ►
<br /> 10 Date business started ar acquired(month,day,year) 11 Cbsing morrth of accounting year
<br /> � December
<br /> 12 First daEe wages or annuities were paid-or will be paFd(month;day,year). Nota: !f applicant is a withholding agenG enter date frtcome wril!
<br /> first be paid to nonvesident allen. (monih, day year) . . ► N/A
<br /> 13 Highest numb?er of employees expected in the next 12 months.Note:If the applicant does not Agricuitural Household Oth�r
<br /> expect to have any employees during the periQd,enter "-�-. � � p ' 0
<br /> 14 et�;ck cne box that best describ�.s the prinCipal activity af your business. ❑ Heakh care&social assistanee ❑ Wholesale-agenttbroker
<br /> ❑ Constructitt3n � Rerital&leasing ❑ Transp�rtatlon-&warehousing ❑ q��mmodation&food s�vice ❑ Whotesale-oft� ❑ Retail
<br /> � Real estate 0 'Manufacturing ❑ Finance&insurance ❑ Other(specifjr)
<br /> 15 kndicate principal line of inerchandise sotd;specific construction work done;products p[oduced;or services provided.
<br /> Development of real estate into resldential properties
<br /> 16a Has the applieant ever applied for art empioyer identification number for this or any other business7 . . . . ❑ Y�` 0 No
<br /> Note:(f"Yes,"please complete lines 16b end 16c.
<br /> 16b If you checked"Yes"on line 16a,give appllcanYs legaf name and trade name shown on prior applicaqon if different from line 1 or 2 above.
<br /> Legal name ► N/A Trade name ► N/A
<br /> 16c Approximate date when,and city and state where,the application was filed. Enter previous employer identification numb�r if known.
<br /> Approximate tla[e when filed(mo.,day,y�ar) Cny and state where filed Prevfous EIN
<br /> N/A N/A ;N/A
<br /> Complete this sec6on only if you v�n[W autl�orize the named individual to receive the entitys EIN aM ar�u questions about the completiai of this form.
<br /> Third oesignee's name Oesignee's tdephone munbe ph�e area cod�
<br /> Party Joan M.Boddlcker,Rider Bennett Egan 8 Arundel,LLP ( g12 )340-7932
<br /> Resignee Address and ZIP eode Designee's fex rnimt�pnclude area code)
<br /> 333 S.7th Street,Suite 1900,Minneapolis,MN 55402 613 )34Q-7900
<br /> Underpenalties of,PgJuY.I dedare d�at I have exammed this�pl�apan,and to the best of my knowledge snd txlief,t fs true,carea.and canpl�e.
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<br /> AppAca�'s telephone numbd'�incA���e8 wd�
<br /> Name anci title(type or p r.�riy� ► Gregg W.S in afel, hief Manager � �
<br /> Applicant's tax number(f�c1utle area sode)
<br /> .Si nawre r Da�e ► �� ( )
<br /> For Priv Act antJ Pape : k Reduc n Act Noti�e.se separaie instruetions. Cat.No.16o55N Fortn $�-4 (Rev,12-2no7)
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