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  5. M.M. DEREN, M.D., P.C.

M.M. DEREN, M.D., P.C.

Company Details

Entity Name: M.M. DEREN, M.D., P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Dissolved
Date Formed: 04 Mar 1974
Date of dissolution: 29 Sep 2015
Business ALEI: 0035889
Annual report due: 29 Mar 2014
Business address: 125 SHAW ST., NEW LONDON, CT, 06320
ZIP code: 06320
County: New London
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: michaelddd@aol.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2014 060905653 2015-03-30 M.M. DEREN, M.D., P.C. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-09-01
Business code 621111
Sponsor’s telephone number 8604435469
Plan sponsor’s address 125 SHAW STREET, UNIT 1, NEW LONDON, CT, 06320

Signature of
Role Plan administrator
Date 2015-03-30
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-03-30
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2014 060905653 2015-03-30 M.M. DEREN, M.D., P.C. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-09-01
Business code 621111
Sponsor’s telephone number 8604435469
Plan sponsor’s address 125 SHAW STREET, UNIT 1, NEW LONDON, CT, 06320

Signature of
Role Plan administrator
Date 2015-03-30
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-03-30
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2013 060905653 2014-10-13 M.M. DEREN, M.D., P.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-09-01
Business code 621111
Sponsor’s telephone number 8604435469
Plan sponsor’s address 125 SHAW STREET, UNIT 1, NEW LONDON, CT, 06320

Signature of
Role Plan administrator
Date 2014-10-13
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-13
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2012 060905653 2013-10-10 M.M. DEREN, M.D., P.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-09-01
Business code 621111
Sponsor’s telephone number 8604435469
Plan sponsor’s address 125 SHAW STREET, UNIT 1, NEW LONDON, CT, 06320

Signature of
Role Plan administrator
Date 2013-10-10
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-10
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2011 060905653 2012-10-03 M.M. DEREN, M.D., P.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-09-01
Business code 621111
Sponsor’s telephone number 8604435469
Plan sponsor’s address 125 SHAW STREET, UNIT 1, NEW LONDON, CT, 06320

Plan administrator’s name and address
Administrator’s EIN 060905653
Plan administrator’s name M.M. DEREN, M.D., P.C.
Plan administrator’s address 125 SHAW STREET, UNIT 1, NEW LONDON, CT, 06320
Administrator’s telephone number 8604435469

Signature of
Role Plan administrator
Date 2012-10-03
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2010 060905653 2011-03-08 M.M. DEREN, M.D., P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-09-01
Business code 621111
Sponsor’s telephone number 8604435469
Plan sponsor’s mailing address 21 MONTAUK AVENUE, SUITE 104, NEW LONDON, CT, 06320
Plan sponsor’s address 21 MONTAUK AVENUE, SUITE 104, NEW LONDON, CT, 06320

Plan administrator’s name and address
Administrator’s EIN 060905653
Plan administrator’s name M.M. DEREN, M.D., P.C.
Plan administrator’s address 21 MONTAUK AVENUE, SUITE 104, NEW LONDON, CT, 06320
Administrator’s telephone number 8604435469

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 2
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-03-08
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
M.M. DEREN, M.D., P.C., PROFIT SHARING PLAN & TRUST 2010 060905653 2011-03-01 M.M. DEREN, M.D., P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-09-01
Business code 621111
Sponsor’s telephone number 8604435469
Plan sponsor’s address 21 MONTAUK AVENUE, SUITE 104, NEW LONDON, CT, 06320

Plan administrator’s name and address
Administrator’s EIN 060905653
Plan administrator’s name M.M. DEREN, M.D., P.C.
Plan administrator’s address 21 MONTAUK AVENUE, SUITE 104, NEW LONDON, CT, 06320
Administrator’s telephone number 8604435469

Signature of
Role Plan administrator
Date 2011-03-01
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2010 060905653 2011-10-10 M.M. DEREN, M.D., P.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-09-01
Business code 621111
Sponsor’s telephone number 8604435469
Plan sponsor’s address 21 MONTAUK AVENUE, SUITE 104, NEW LONDON, CT, 06320

Plan administrator’s name and address
Administrator’s EIN 060905653
Plan administrator’s name M.M. DEREN, M.D., P.C.
Plan administrator’s address 21 MONTAUK AVENUE, SUITE 104, NEW LONDON, CT, 06320
Administrator’s telephone number 8604435469

Signature of
Role Plan administrator
Date 2011-10-10
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature
M.M. DEREN, M.D., P.C. PROFIT SHARING PLAN & TRUST 2009 060905653 2010-10-05 M.M. DEREN, M.D., P.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-09-01
Business code 621111
Sponsor’s telephone number 8604435469
Plan sponsor’s address 21 MONTAUK AVENUE, SUITE 104, NEW LONDON, CT, 06320

Plan administrator’s name and address
Administrator’s EIN 060905653
Plan administrator’s name M.M. DEREN, M.D., P.C.
Plan administrator’s address 21 MONTAUK AVENUE, SUITE 104, NEW LONDON, CT, 06320
Administrator’s telephone number 8604435469

Signature of
Role Plan administrator
Date 2010-10-05
Name of individual signing MIECRYLOW DEREN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address E-Mail Residence address
JAMES F. BRENNAN Agent 2 UNION PLAZA, SUITE 200, NEW LONDON, CT, 06320, United States michaelddd@aol.com 57 ANDERSON ROAD, POMFRET CENTER, CT, 06259, United States

Officer

Name Role Business address Residence address
MICHAEL M. DEREN Officer 125 SHAW ST., NEW LONDON, CT, 06320, United States 106 NILES HILL RD, NEW LONDON, CT, 06320, United States
ANNE MARIE DEREN Officer 125 SHAW ST., NEW LONDON, CT, 06320, United States 106 NILES HILL ROAD, NEW LONDON, CT, 06320, United States

History

Type Old value New value Date of change
Name change PAUL J. GERITY, M.D., P.C. M.M. DEREN, M.D., P.C. 1993-07-27

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0005403632 2015-09-29 2015-09-29 Dissolution Certificate of Dissolution No data
0004818481 2013-03-09 No data Annual Report Annual Report 2013
0004557397 2012-03-28 No data Annual Report Annual Report 2012
0004433992 2011-03-21 No data Annual Report Annual Report 2011
0004149368 2010-03-09 No data Annual Report Annual Report 2010
0003901660 2009-03-03 No data Annual Report Annual Report 2009
0003668903 2008-03-24 No data Annual Report Annual Report 2008
0003441045 2007-04-18 No data Annual Report Annual Report 2007
0003192305 2006-03-21 No data Annual Report Annual Report 2006
0002946590 2005-03-31 No data Annual Report Annual Report 2005

Related by officers

JAMES F. BRENNAN

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Related by address

No related companies by address

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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