| Entity Name: | FORMATIV HEALTH MANAGEMENT, INC. |
| Jurisdiction: | Connecticut |
| Legal type: | Stock |
| Citizenship: | Foreign |
| Status: | Withdrawn |
| Sub status: | Annual report past due |
| Date Formed: | 21 Dec 2017 |
| Business ALEI: | 1260218 |
| Annual report due: | 21 Dec 2022 |
| NAICS code: | 541219 - Other Accounting Services |
| Business address: | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States |
| Mailing address: | 4875 Belfort Rd, Jacksonville, FL, United States, 32256 |
| Place of Formation: | DELAWARE |
| E-Mail: | william.daniel@brownwinick.com |
| Name | Role | Business address |
|---|---|---|
| Secretary of State | Agent | 165 Capitol Ave., P.O. BOX 150470, Hartford, CT, 06115-0470, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| EUGENE TANGNEY | Director | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States |
| HOLLY KOEHLER | Director | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States |
| MARK SOLAZZO | Director | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States | 2000 MARCUS AVENUE, NEW HYDE PARK, NY, 11042, United States |
| LAURENCE KRAEMER | Director | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States | 2000 MARCUS AVENUE, NEW HYDE PARK, NY, 11042, United States |
| JOSEPH MOSCOLA | Director | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States |
| MICHELE CUSACK | Director | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States | 2000 MARCUS AVENUE, NEW HYDE PARK, NY, 11042, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| LAURENCE KRAEMER | Officer | 4875 BELFORT RD, JACKSONVILLE, FL, 32256, United States | 2000 MARCUS AVENUE, NEW HYDE PARK, NY, 11042, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0010614912 | 2022-05-31 | 2022-05-31 | Withdrawal | Certificate of Withdrawal | No data |
| BF-0009830210 | 2021-11-22 | No data | Annual Report | Annual Report | No data |
| 0007024845 | 2020-11-23 | No data | Annual Report | Annual Report | 2020 |
| 0006691599 | 2019-12-05 | No data | Annual Report | Annual Report | 2019 |
| 0006542264 | 2019-04-16 | 2019-04-16 | Change of Business Address | Business Address Change | No data |
| 0006274700 | 2018-11-09 | No data | Annual Report | Annual Report | 2018 |
| 0006006043 | 2017-12-21 | 2017-12-21 | Business Registration | Certificate of Authority | No data |
Date of last update: 25 Nov 2024
Sources: Connecticut's Official State Website
