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FAMILY PHYSICIANS OF WEST HAVEN, LLC

Company Details

Entity Name: FAMILY PHYSICIANS OF WEST HAVEN, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Dissolved
Date Formed: 01 Feb 1999
Date of dissolution: 01 Jan 2015
Business ALEI: 0612709
Business address: 755 CAMPBELL AVE., WEST HAVEN, CT, 06516
ZIP code: 06516
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: slpallotto@yahoo.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY PHYSICIANS OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2013 061535820 2014-05-21 FAMILY PHYSICIANS OF WEST HAVEN, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2039312832
Plan sponsor’s address 755 CAMPBELL AVENUE, WEST HAVEN, CT, 065163715
FAMILY PHYSICIANS OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2012 061535820 2013-05-29 FAMILY PHYSICIANS OF WEST HAVEN, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2039312832
Plan sponsor’s address 755 CAMPBELL AVENUE, WEST HAVEN, CT, 065163715

Signature of

Role Plan administrator
Date 2013-05-29
Name of individual signing WILLIAM ROSNER, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-29
Name of individual signing WILLIAM ROSNER, MD
Valid signature Filed with authorized/valid electronic signature
FAMILY PHYSICIANS OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2011 061535820 2012-05-22 FAMILY PHYSICIANS OF WEST HAVEN, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2039312832
Plan sponsor’s address 755 CAMPBELL AVENUE, WEST HAVEN, CT, 065163715

Plan administrator’s name and address

Administrator’s EIN 061535820
Plan administrator’s name FAMILY PHYSICIANS OF WEST HAVEN, LLC
Plan administrator’s address 755 CAMPBELL AVENUE, WEST HAVEN, CT, 065163715
Administrator’s telephone number 2039312832

Signature of

Role Plan administrator
Date 2012-05-22
Name of individual signing WILLIAM ROSNER, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-05-22
Name of individual signing WILLIAM ROSNER, MD
Valid signature Filed with authorized/valid electronic signature
FAMILY PHYSICIANS OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2010 061535820 2011-06-15 FAMILY PHYSICIANS OF WEST HAVEN, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2039312832
Plan sponsor’s address 755 CAMPBELL AVENUE, WEST HAVEN, CT, 065163715

Plan administrator’s name and address

Administrator’s EIN 061535820
Plan administrator’s name FAMILY PHYSICIANS OF WEST HAVEN, LLC
Plan administrator’s address 755 CAMPBELL AVENUE, WEST HAVEN, CT, 065163715
Administrator’s telephone number 2039312832

Signature of

Role Plan administrator
Date 2011-06-14
Name of individual signing WILLIAM ROSNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-06-14
Name of individual signing WILLIAM ROSNER
Valid signature Filed with authorized/valid electronic signature
FAMILY PHYSICIANS OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2009 061535820 2010-07-14 FAMILY PHYSICIANS OF WEST HAVEN, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2039312832
Plan sponsor’s address 755 CAMPBELL AVENUE, WEST HAVEN, CT, 065163715

Plan administrator’s name and address

Administrator’s EIN 061535820
Plan administrator’s name FAMILY PHYSICIANS OF WEST HAVEN, LLC
Plan administrator’s address 755 CAMPBELL AVENUE, WEST HAVEN, CT, 065163715
Administrator’s telephone number 2039312832

Signature of

Role Plan administrator
Date 2010-07-08
Name of individual signing WILLIAM E. ROSNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-08
Name of individual signing WILLIAM E. ROSNER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Residence address
WILLIAM F. CUMMINGS Agent 185 ASYLUM STREET, 35TH FLOOR, HARTFORD, CT, 06103, United States 110 JENNIFER DRIVE, HEBRON, CT, 06248, United States

Officer

Name Role Business address Residence address
WILLIAM E. ROSNER M.D. Officer 755 CAMPBELL AVE, WEST HAVEN, CT, 06516, United States 196 NEW HAVEN AVE, APT 217, DERBY, CT, 06418, United States

History

Type Old value New value Date of change
Name change FPAWH, LLC FAMILY PHYSICIANS OF WEST HAVEN, LLC 1999-02-18

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0005625633 2016-08-09 2015-01-01 Dissolution Certificate of Dissolution No data
0005304279 2015-03-26 No data Annual Report Annual Report 2014
0004903295 2013-07-23 No data Annual Report Annual Report 2013
0004570842 2012-04-12 No data Annual Report Annual Report 2012
0004105723 2010-02-18 No data Annual Report Annual Report 2011
0004079392 2010-01-12 No data Annual Report Annual Report 2010
0003859020 2009-02-02 No data Annual Report Annual Report 2009
0003681693 2008-05-14 No data Annual Report Annual Report 2008
0003681684 2008-05-14 No data Annual Report Annual Report 2007
0003242932 2006-07-10 No data Annual Report Annual Report 2006

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website