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  5. FAMILY MEDICINE CLINIC, P.C.

FAMILY MEDICINE CLINIC, P.C.

Company Details

Name: FAMILY MEDICINE CLINIC, P.C.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Good Standing
Date of registration: 21 Sep 1984 (40 years ago)
Entity Number: 19871588181
ZIP code: 80123
County: Jefferson County
Place of Formation: COLORADO
Principal Address: 6179 S Balsam Way Ste 110 Littleton CO 80123 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY MEDICINE CLINIC P C 401K PLAN 2019 840967619 2020-03-03 FAMILY MEDICINE CLINIC P C 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 3039726992
Plan sponsor’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123

Signature of
Role Plan administrator
Date 2020-03-03
Name of individual signing JACKIE KARSTEN
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE CLINIC P C 401K PLAN 2018 840967619 2019-07-02 FAMILY MEDICINE CLINIC P C 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 3039726992
Plan sponsor’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123

Signature of
Role Plan administrator
Date 2019-07-02
Name of individual signing JACKIE KARSTEN
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE CLINIC P C 401K PLAN 2017 840967619 2018-06-29 FAMILY MEDICINE CLINIC P C 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 3039726992
Plan sponsor’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123

Signature of
Role Plan administrator
Date 2018-06-29
Name of individual signing JACKIE KARSTEN
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE CLINIC P C 401K PLAN 2016 840967619 2017-06-23 FAMILY MEDICINE CLINIC P C 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 3039726992
Plan sponsor’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123

Signature of
Role Plan administrator
Date 2017-06-23
Name of individual signing JACKIE KARSTEN
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE CLINIC P C 401K PLAN 2015 840967619 2016-10-03 FAMILY MEDICINE CLINIC P C 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 3039726992
Plan sponsor’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123

Signature of
Role Plan administrator
Date 2016-10-03
Name of individual signing JACKIE KARSTEN
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE CLINIC P C 401K PLAN 2014 840967619 2015-06-29 FAMILY MEDICINE CLINIC P C 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 3039726992
Plan sponsor’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123

Signature of
Role Plan administrator
Date 2015-06-29
Name of individual signing JACKIE KARSTEN
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE CLINIC P C 401K PLAN 2013 840967619 2014-07-10 FAMILY MEDICINE CLINIC P C 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 3039726992
Plan sponsor’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123

Plan administrator’s name and address
Administrator’s EIN 840967619
Plan administrator’s name FAMILY MEDICINE CLINIC P C
Plan administrator’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123
Administrator’s telephone number 3039726992

Signature of
Role Plan administrator
Date 2014-07-10
Name of individual signing JACKIE KARSTEN
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE CLINIC P C 401K PLAN 2012 840967619 2013-06-06 FAMILY MEDICINE CLINIC P C 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 3039726992
Plan sponsor’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123

Plan administrator’s name and address
Administrator’s EIN 840967619
Plan administrator’s name FAMILY MEDICINE CLINIC P C
Plan administrator’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123
Administrator’s telephone number 3039726992

Signature of
Role Plan administrator
Date 2013-06-06
Name of individual signing JACKIE KARSTEN
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE CLINIC P C 401K PLAN 2011 840967619 2012-06-07 FAMILY MEDICINE CLINIC P C 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 3039726992
Plan sponsor’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123

Plan administrator’s name and address
Administrator’s EIN 840967619
Plan administrator’s name FAMILY MEDICINE CLINIC P C
Plan administrator’s address 6179 S BALSAM WAY, 110, LITTLETON, CO, 80123
Administrator’s telephone number 3039726992

Signature of
Role Plan administrator
Date 2012-06-07
Name of individual signing JACKIE KARSTEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
STEVEN A. SINGER Agent 6179 S Balsam Way Ste 110 Littleton CO 80123 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20241879815 File Report 2024-08-23 2024-08-23 No data Principal address changed, Change in registered agent information
20231914302 File Report 2023-08-31 2023-08-31 No data Change in registered agent information
20221802630 File Report 2022-08-23 2022-08-23 No data No data
20211771157 File Report 2021-08-24 2021-08-24 No data No data
20201721065 File Report 2020-08-24 2020-08-24 No data No data
20191667921 File Report 2019-08-23 2019-08-23 No data No data
20181689021 File Report 2018-08-29 2018-08-29 No data No data
20171627440 File Report 2017-08-23 2017-08-23 No data No data
20161793916 File Report 2016-11-25 2016-11-25 No data No data
20151577007 File Report 2015-09-03 2015-09-03 No data No data

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Colorado's Secretary of State

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