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  5. FORUM FAMILY MEDICINE, P.C.

FORUM FAMILY MEDICINE, P.C.

Company Details

Name: FORUM FAMILY MEDICINE, P.C.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Good Standing
Date of registration: 11 Mar 2003 (22 years ago)
Entity Number: 20031081002
ZIP code: 80014
County: Arapahoe County
Place of Formation: COLORADO
Principal Address: 14001 E Iliff Ave Ste 109 Aurora CO 80014 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2023 680545169 2024-09-19 FORUM FAMILY MEDICINE 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 80014

Signature of
Role Plan administrator
Date 2024-09-19
Name of individual signing PHILLIP QUINTANA
Valid signature Filed with authorized/valid electronic signature
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2022 680545169 2023-11-09 FORUM FAMILY MEDICINE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 80014

Signature of
Role Plan administrator
Date 2023-11-09
Name of individual signing PHILLIP QUINTANA
Valid signature Filed with authorized/valid electronic signature
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2021 680545169 2022-06-27 FORUM FAMILY MEDICINE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 80014

Signature of
Role Plan administrator
Date 2022-06-27
Name of individual signing PHILLIP QUINTANA
Valid signature Filed with authorized/valid electronic signature
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2020 680545169 2021-05-10 FORUM FAMILY MEDICINE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 80014

Signature of
Role Plan administrator
Date 2021-05-10
Name of individual signing PHILLIP QUINTANA
Valid signature Filed with authorized/valid electronic signature
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2019 680545169 2020-05-14 FORUM FAMILY MEDICINE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 80014

Signature of
Role Plan administrator
Date 2020-05-14
Name of individual signing PHILLIP QUINTANA
Valid signature Filed with authorized/valid electronic signature
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2018 680545169 2019-07-18 FORUM FAMILY MEDICINE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 80014

Signature of
Role Plan administrator
Date 2019-07-18
Name of individual signing PHILLIP QUINTANA
Valid signature Filed with authorized/valid electronic signature
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2017 680545169 2018-07-22 FORUM FAMILY MEDICINE 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 80014

Signature of
Role Plan administrator
Date 2018-07-22
Name of individual signing PHILLIP QUINTANA
Valid signature Filed with authorized/valid electronic signature
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2016 680545169 2017-06-25 FORUM FAMILY MEDICINE 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 7100 E. BELLEVIEW AVE., SUITE 300, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 680545169
Plan administrator’s name FORUM FAMILY MEDICINE
Plan administrator’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 800141424
Administrator’s telephone number 3039961020

Signature of
Role Plan administrator
Date 2017-06-25
Name of individual signing PHILLIP QUINTANA
Valid signature Filed with authorized/valid electronic signature
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2015 680545169 2016-09-14 FORUM FAMILY MEDICINE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 7100 E. BELLEVIEW AVE., SUITE 300, GREENWOOD VILLAGE, CO, 80111

Plan administrator’s name and address
Administrator’s EIN 680545169
Plan administrator’s name FORUM FAMILY MEDICINE
Plan administrator’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 800141424
Administrator’s telephone number 3039961020

Signature of
Role Plan administrator
Date 2016-09-14
Name of individual signing PHILLIP QUINTANA
Valid signature Filed with authorized/valid electronic signature
FORUM FAMILY MEDICINE 401K PROFIT SHARING PLAN AND TRUST 2014 680545169 2015-01-19 FORUM FAMILY MEDICINE 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3039961020
Plan sponsor’s address 14001 EAST ILIFF AVENUE STE 109, AURORA, CO, 800141424

Signature of
Role Plan administrator
Date 2015-01-19
Name of individual signing PHILLIP D QUINTANA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
RICK TORMOHLEN Agent 14001 E Iliff Ave Ste 109 Aurora CO 80014 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20241205935 File Report 2024-02-23 2024-02-23 No data Principal address changed, Change in registered agent information
20231194273 File Report 2023-02-23 2023-02-23 No data Principal address changed, Change in registered agent information
20221487253 File Report 2022-05-14 2022-05-14 No data No data
20211483953 File Report 2021-05-24 2021-05-24 No data No data
20201456245 File Report 2020-05-26 2020-05-26 No data No data
20191431297 File Report 2019-05-24 2019-05-24 No data No data
20181433865 File Report 2018-05-28 2018-05-28 No data No data
20171392044 File Report 2017-05-24 2017-05-24 No data No data
20161328810 File Report 2016-05-10 2016-05-10 No data No data
20151127609 File Report 2015-02-23 2015-02-23 No data No data

Related by officers

No related officers

Related by address

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Date of last update: 13 Jan 2025

Sources: Colorado's Secretary of State

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