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  5. INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C., Delinquent October 1, 2023

INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C., Delinquent October 1, 2023

Company Details

Name: INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C., Delinquent October 1, 2023
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Delinquent
Date of registration: 06 May 1991 (34 years ago)
Date dissolved: 25 Apr 2022
Entity Number: 19911032520
ZIP code: 80528
County: Larimer County
Place of Formation: COLORADO
Principal Address: 2021 Battlecreek Dr #B FT COLLINS CO 80528 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2021 841174590 2022-06-13 INTERNAL MEDICINE CLINIC OF FORT COLLINS P.C 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 2021 BATTLECREEK DR UNIT B, FORT COLLINS, CO, 80528

Signature of
Role Plan administrator
Date 2022-06-13
Name of individual signing ALICIA GOOSSENS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-13
Name of individual signing ALICIA GOOSSENS
Valid signature Filed with incorrect/unrecognized electronic signature
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2020 841174590 2021-05-07 INTERNAL MEDICINE CLINIC OF FORT COLLINS P.C 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 2021 BATTLECREEK DR UNIT B, FORT COLLINS, CO, 80528

Signature of
Role Plan administrator
Date 2021-05-07
Name of individual signing ALICIA GOOSSENS
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2019 841174590 2020-06-02 INTERNAL MEDICINE CLINIC OF FORT COLLINS P.C 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 2021 BATTLECREEK DR UNIT B, FORT COLLINS, CO, 80528

Signature of
Role Plan administrator
Date 2020-06-02
Name of individual signing DEBRA CHILDRESS
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2018 841174590 2019-09-04 INTERNAL MEDICINE CLINIC OF FORT COLLINS P.C 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 2021 BATTLECREEK DR UNIT B, FORT COLLINS, CO, 80528

Signature of
Role Plan administrator
Date 2019-09-04
Name of individual signing DEBBIE CHILDRESS
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2017 841174590 2018-06-08 INTERNAL MEDICINE CLINIC OF FORT COLLINS P.C 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 2021 BATTLECREEK DR UNIT B, FORT COLLINS, CO, 80528

Signature of
Role Plan administrator
Date 2018-06-08
Name of individual signing DEBBIE CHILDRESS
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2016 841174590 2017-09-01 INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 2021 BATTLECREEK DR UNIT B, FORT COLLINS, CO, 80528

Signature of
Role Plan administrator
Date 2017-06-20
Name of individual signing DEBRA S CHILDRESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-01
Name of individual signing DEBRA S CHILDRESS
Valid signature Filed with incorrect/unrecognized electronic signature
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2015 841174590 2016-07-01 INTERNAL MEDICINE CLINIC OF FORT COLLINS P.C 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 2021 BATTLECREEK DRIVE, FORT COLLINS, CO, 80528

Signature of
Role Plan administrator
Date 2016-07-01
Name of individual signing DEBRA CHILDRESS
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2014 841174590 2015-06-12 INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 1100 POUDRE RIVER DRIVE, FORT COLLINS, CO, 80524

Signature of
Role Plan administrator
Date 2015-06-12
Name of individual signing DEBBIE CHILDRESS
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2013 841174590 2014-09-08 INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 1100 POUDRE RIVER DRIVE, FORT COLLINS, CO, 80524

Signature of
Role Plan administrator
Date 2014-09-08
Name of individual signing DEBBIE CHILDRESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-09-08
Name of individual signing DEBBIE CHILDRESS
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 401(K) PLAN 2012 841174590 2013-09-25 INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 9702249508
Plan sponsor’s address 1100 POUDRE RIVER DRIVE, FORT COLLINS, CO, 80524

Signature of
Role Plan administrator
Date 2013-09-25
Name of individual signing DEBRA CHILDRESS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-25
Name of individual signing DEBRA CHILDRESS
Valid signature Filed with authorized/valid electronic signature

Transaction History

Transaction ID Type Date Effective date Name Comment
20221416166 Dissolve a Profit Corporation 2022-04-25 2022-04-25 INTERNAL MEDICINE CLINIC OF FORT COLLINS, P.C., Dissolved April 25, 2022 No data
20221416461 File Report 2022-04-25 2022-04-25 No data No data
20211495910 File Report 2021-05-25 2021-05-25 No data No data
20201365504 File Report 2020-04-24 2020-04-24 No data No data
20191371227 File Report 2019-04-30 2019-04-30 No data No data
20181326890 File Report 2018-04-23 2018-04-23 No data No data
20171319590 File Report 2017-04-25 2017-04-25 No data No data
20161458755 File Report 2016-07-05 2016-07-05 No data Change of Registered Agent Address / Change of Entity Address
20151295872 File Report 2015-04-29 2015-04-29 No data No data
20141312795 Amend Articles of Incorporation for a Profit Corporation 2014-05-21 2014-05-21 No data No data

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Date of last update: 27 Jan 2025

Sources: Colorado's Secretary of State

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