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C. POTTS INSURANCE AGENCY, LLC

Company Details

Entity Name: C. POTTS INSURANCE AGENCY, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Dissolved
Date Formed: 04 Feb 2000 (Companies founded in February 2000)
Date of dissolution: 16 Oct 2019
Business ALEI: 0642555
Business address: 67 PARKER RD, WILLINGTON, CT, 06279, United States
Mailing address: PO BOX 151, WILLINGTON, CT, United States, 06279
ZIP code: 06279 (Companies in Tolland, 06279)
County: Tolland
Place of Formation: CONNECTICUT
E-Mail: cp_potts@hotmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2018 061575627 2019-05-03 C POTTS INSURANCE AGENCY, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Sponsor’s telephone number 8604280951
Plan sponsor’s address 67 PARKER RD, WILLINGTON, CT, 06279

Plan administrator’s name and address
Administrator’s EIN 061575627
Plan administrator’s name C POTTS INSURANCE AGENCY, LLC
Plan administrator’s address 67 PARKER RD, WILLINGTON, CT, 06279
Administrator’s telephone number 8604280951

Signature of
Role Plan administrator
Date 2019-05-03
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2018 061575627 2019-09-12 C POTTS INSURANCE AGENCY, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Sponsor’s telephone number 8604567991
Plan sponsor’s address 67 PARKER RD, WILLINGTON, CT, 06279

Signature of
Role Plan administrator
Date 2019-09-12
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2017 061575627 2018-07-09 C POTTS INSURANCE AGENCY, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Sponsor’s telephone number 8604567991
Plan sponsor’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250

Plan administrator’s name and address
Administrator’s EIN 061575627
Plan administrator’s name C POTTS INSURANCE AGENCY, LLC
Plan administrator’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250
Administrator’s telephone number 8604567991

Signature of
Role Plan administrator
Date 2018-07-09
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2016 061575627 2017-06-13 C POTTS INSURANCE AGENCY, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Sponsor’s telephone number 8604567991
Plan sponsor’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250

Plan administrator’s name and address
Administrator’s EIN 061575627
Plan administrator’s name C POTTS INSURANCE AGENCY, LLC
Plan administrator’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250
Administrator’s telephone number 8604567991

Signature of
Role Plan administrator
Date 2017-06-13
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2015 061575627 2016-08-18 C POTTS INSURANCE AGENCY, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Sponsor’s telephone number 8604567991
Plan sponsor’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250

Plan administrator’s name and address
Administrator’s EIN 061575627
Plan administrator’s name C POTTS INSURANCE AGENCY, LLC
Plan administrator’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250
Administrator’s telephone number 8604567991

Signature of
Role Plan administrator
Date 2016-08-18
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2014 061575627 2015-08-04 C POTTS INSURANCE AGENCY, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Sponsor’s telephone number 8604567991
Plan sponsor’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250

Plan administrator’s name and address
Administrator’s EIN 061575627
Plan administrator’s name C POTTS INSURANCE AGENCY, LLC
Plan administrator’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250
Administrator’s telephone number 8604567991

Signature of
Role Plan administrator
Date 2015-08-04
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2013 061575627 2014-07-10 C POTTS INSURANCE AGENCY, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Sponsor’s telephone number 8604567991
Plan sponsor’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250

Plan administrator’s name and address
Administrator’s EIN 061575627
Plan administrator’s name C POTTS INSURANCE AGENCY, LLC
Plan administrator’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250
Administrator’s telephone number 8604567991

Signature of
Role Plan administrator
Date 2014-07-10
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2012 061575627 2013-04-11 C POTTS INSURANCE AGENCY, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Sponsor’s telephone number 8604567991
Plan sponsor’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250

Plan administrator’s name and address
Administrator’s EIN 061575627
Plan administrator’s name C POTTS INSURANCE AGENCY, LLC
Plan administrator’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250
Administrator’s telephone number 8604567991

Signature of
Role Plan administrator
Date 2013-04-11
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2011 061575627 2012-05-18 C POTTS INSURANCE AGENCY, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Plan sponsor’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250

Plan administrator’s name and address
Administrator’s EIN 061575627
Plan administrator’s name C POTTS INSURANCE AGENCY, LLC
Plan administrator’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250
Administrator’s telephone number 8604567991

Signature of
Role Plan administrator
Date 2012-05-18
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature
C POTTS INSURANCE AGENCY, LLC 401(K) PS PLAN 2010 061575627 2011-04-15 C POTTS INSURANCE AGENCY, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 524210
Sponsor’s telephone number 8604567991
Plan sponsor’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250

Plan administrator’s name and address
Administrator’s EIN 061575627
Plan administrator’s name C POTTS INSURANCE AGENCY, LLC
Plan administrator’s address 10 HIGGINS HWY, SUITE 6, MANSFIELD CENTER, CT, 06250
Administrator’s telephone number 8604567991

Signature of
Role Plan administrator
Date 2011-04-15
Name of individual signing CHRISTINE POTTS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Residence address
CHRISTINE POTTS Agent 10 HIGGINS HIGHWAY, STE 6, MANSFIELD, CT, United States 67 PARKER RD, WILLINGTON, CT, United States

Officer

Name Role Business address Residence address
CHRISTINE POTTS Officer 67 PARKER RD, WILLINGTON, CT, 06279, United States 67 PARKER RD, WILLINGTON, CT, United States

History

Type Old value New value Date of change
Name change POTTS INSURANCE AGENCY, LLC. C. POTTS INSURANCE AGENCY, LLC 2000-03-20

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0006661898 2019-10-16 2019-10-16 Dissolution Certificate of Dissolution No data
0006485854 2019-03-22 No data Annual Report Annual Report 2019
0006063994 2018-02-08 No data Annual Report Annual Report 2018
0005761508 2017-02-03 No data Annual Report Annual Report 2017
0005485142 2016-02-10 No data Annual Report Annual Report 2016
0005277419 2015-02-11 No data Annual Report Annual Report 2015
0005040908 2014-02-12 No data Annual Report Annual Report 2014
0004790527 2013-01-29 No data Annual Report Annual Report 2013
0004505887 2012-01-17 No data Annual Report Annual Report 2012
0004409999 2011-02-18 No data Annual Report Annual Report 2011

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 11 Nov 2024

Sources: Connecticut's Official State Website

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