| Entity Name: | FAMILY MEDICINE ASSOCIATES, LLC |
| Jurisdiction: | Connecticut |
| Legal type: | LLC |
| Citizenship: | Domestic |
| Status: | Forfeited |
| Date Formed: | 16 Nov 2007 |
| Business ALEI: | 0919269 |
| Annual report due: | 31 Mar 2012 |
| Business address: | 1250 BOSTON POST ROAD, OLD SAYBROOK, CT, 06475 |
| ZIP code: | 06475 |
| County: | Middlesex |
| Place of Formation: | CONNECTICUT |
| E-Mail: | fmeda1250@yahoo.com |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUSANNA THOMAS 401 K PROFIT SHARING PLAN TRUST | 2014 | 061303820 | 2015-06-30 | FAMILY MEDICINE ASSOCIATES | 12 | |||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2015-06-30 |
| Name of individual signing | RENA MAHER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2000-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 8603889250 |
| Plan sponsor’s address | 1250 BOSTON POST RD, OLD SAYBROOK, CT, 064754405 |
Signature of
| Role | Plan administrator |
| Date | 2014-06-02 |
| Name of individual signing | JAN BULGINI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2000-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 8603889250 |
| Plan sponsor’s address | 1250 BOSTON POST RD, OLD SAYBROOK, CT, 064754405 |
Signature of
| Role | Plan administrator |
| Date | 2013-07-23 |
| Name of individual signing | FAMILY MEDICINE ASSOCIATES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2000-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 8603889250 |
| Plan sponsor’s address | 1250 BOSTON POST RD, OLD SAYBROOK, CT, 064754405 |
Plan administrator’s name and address
| Administrator’s EIN | 061303820 |
| Plan administrator’s name | FAMILY MEDICINE ASSOCIATES |
| Plan administrator’s address | 1250 BOSTON POST RD, OLD SAYBROOK, CT, 064754405 |
| Administrator’s telephone number | 8603889250 |
Signature of
| Role | Plan administrator |
| Date | 2012-07-27 |
| Name of individual signing | FAMILY MEDICINE ASSOCIATES |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Business address | Residence address | |
|---|---|---|---|---|
| SUSANNA THOMAS M.D. | Agent | 1250 BOSTON POST ROAD, OLD SAYBROOK, CT, 06475, United States | fmeda1250@yahoo.com | 71 DROMARA ROAD, GUILFORD, CT, 06437, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| SUSANNA THOMAS | Officer | 1250 BOSTON POST ROAD, OLD SAYBROOK, CT, 06475, United States | 71 DROMARA ROAD, GUILFORD, CT, 06437, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0011008908 | 2022-09-19 | No data | Administrative Dissolution | Certificate of Dissolution/Revocation | No data |
| BF-0010635247 | 2022-06-10 | No data | Administrative Dissolution | Notice of Intent to Dissolve/Revoke | No data |
| 0004489094 | 2011-12-22 | No data | Annual Report | Annual Report | 2011 |
| 0004328612 | 2011-03-02 | No data | Annual Report | Annual Report | 2010 |
| 0004077226 | 2009-11-30 | No data | Annual Report | Annual Report | 2009 |
| 0003829840 | 2008-11-17 | No data | Annual Report | Annual Report | 2008 |
| 0003575861 | 2007-11-16 | No data | Business Formation | Certificate of Organization | No data |
Date of last update: 25 Nov 2024
Sources: Connecticut's Official State Website
