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  5. BURT B. KATUBIG, M.D., PLLC

BURT B. KATUBIG, M.D., PLLC

Company Details

Name: BURT B. KATUBIG, M.D., PLLC
Jurisdiction: Colorado
Legal type: Domestic limited liability company
Status: Good Standing
Date of registration: 31 Dec 2003 (21 years ago)
Entity Number: 20031410884
ZIP code: 80113
County: Arapahoe County
Place of Formation: COLORADO
Principal Address: 499 E Hampden Ave Ste 380 Englewood CO 80113 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BURT B. KATUBIG, M.D. SINGLE K RETIREMENT PLAN 2014 841561980 2015-10-14 BURT B. KATUBIG, M.D., PLLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 7209817755
Plan sponsor’s address 6980 S. POLO RIDGE DR., LITTLETON, CO, 80128
BURT B. KATUBIG, M.D. SINGLE K RETIREMENT PLAN 2013 841561980 2014-10-11 BURT B. KATUBIG, M.D., PLLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 7209817755
Plan sponsor’s address 6980 S. POLO RIDGE DR., LITTLETON, CO, 80128
BURT B. KATUBIG, M.D., PLLC DEFINED BENEFIT PENSION PLAN 2013 841561980 2014-10-11 BURT B. KATUBIG, M.D., PLLC 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 7209817755
Plan sponsor’s address 6980 S. POLO RIDGE DR., LITTLETON, CO, 80128
BURT B. KATUBIG, M.D., PLLC DEFINED BENEFIT PENSION PLAN 2012 841561980 2013-10-12 BURT B. KATUBIG, M.D., PLLC 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 7209817755
Plan sponsor’s address 6980 S. POLO RIDGE, LITTLETON, CO, 80128

Signature of
Role Plan administrator
Date 2013-10-12
Name of individual signing EMILY STRUNK ERPA 000777
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-12
Name of individual signing EMILY STRUNK ERPA 000777
Valid signature Filed with authorized/valid electronic signature
BURT B. KATUBIG, M.D. SINGLE K RETIREMENT PLAN 2012 841561980 2013-10-12 BURT B. KATUBIG, M.D., PLLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 7209817755
Plan sponsor’s address 6980 S. POLO RIDGE, LITTLETON, CO, 80128

Signature of
Role Plan administrator
Date 2013-10-12
Name of individual signing EMILY STRUNK ERPA 000777
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-12
Name of individual signing EMILY STRUNK ERPA 000777
Valid signature Filed with authorized/valid electronic signature
BURT B. KATUBIG, M.D., PLLC DEFINED BENEFIT PENSION PLAN 2011 841561980 2012-09-26 BURT B. KATUBIG, M.D., PLLC 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 7209817755
Plan sponsor’s address 6980 S. POLO RIDGE, LITTLETON, CO, 80128

Plan administrator’s name and address
Administrator’s EIN 841561980
Plan administrator’s name BURT B. KATUBIG, M.D., PLLC
Plan administrator’s address 6980 S. POLO RIDGE, LITTLETON, CO, 80128
Administrator’s telephone number 7209817755

Signature of
Role Plan administrator
Date 2012-09-26
Name of individual signing KRISTINA MARTIN
Valid signature Filed with authorized/valid electronic signature
BURT B. KATUBIG, M.D., PLLC DEFINED BENEFIT PENSION PLAN 2011 841561980 2012-09-25 BURT B. KATUBIG, M.D., PLLC 1
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 7209817755
Plan sponsor’s address 6980 S. POLO RIDGE, LITTLETON, CO, 80128

Plan administrator’s name and address
Administrator’s EIN 841561980
Plan administrator’s name BURT B. KATUBIG, M.D., PLLC
Plan administrator’s address 6980 S. POLO RIDGE, LITTLETON, CO, 80128
Administrator’s telephone number 7209817755

Signature of
Role Plan administrator
Date 2012-09-25
Name of individual signing JAMES Z STONE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-25
Name of individual signing JAMES Z STONE
Valid signature Filed with authorized/valid electronic signature
BURT B. KATUBIG, M.D. SINGLE K RETIREMENT PLAN 2011 841561980 2012-09-24 BURT B. KATUBIG, M.D., PLLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 7209817755
Plan sponsor’s address 6980 S. POLO RIDGE, LITTLETON, CO, 80128

Plan administrator’s name and address
Administrator’s EIN 841561980
Plan administrator’s name BURT B. KATUBIG, M.D., PLLC
Plan administrator’s address 6980 S. POLO RIDGE, LITTLETON, CO, 80128
Administrator’s telephone number 7209817755

Signature of
Role Plan administrator
Date 2012-09-24
Name of individual signing JAMES Z STONE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-24
Name of individual signing JAMES Z STONE
Valid signature Filed with authorized/valid electronic signature

Transaction History

Transaction ID Type Date Effective date Name Comment
20248148111 File Report 2024-10-25 2024-10-25 No data No data
20238226310 File Report 2023-11-25 2023-11-25 No data Change in registered agent information
20228238558 Statement of Change Changing the Registered Agent Information 2022-12-23 2022-12-23 No data Registered agent information changed;Removed agent mailing address;
20228238618 File Report 2022-12-23 2022-12-23 No data Principal address changed, Change in registered agent information
20228233345 Statement of Change Regarding Resignation or Other Termination of Registered Agent 2022-12-21 2022-12-21 No data Registered agent information changed;Registered agent resigned;
20218056582 File Report 2021-11-04 2021-11-04 No data No data
20201950760 File Report 2020-11-02 2020-11-02 No data No data
20191873639 File Report 2019-10-31 2019-10-31 No data No data
20191239276 Statement of Change Changing the Registered Agent Information 2019-03-21 2019-03-21 No data Registered agent information changed;
20181925465 File Report 2018-11-27 2018-11-27 No data No data

Related by officers

No related officers

Related by address

499 E Hampden Ave Ste 380 Englewood CO 80113 US

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Date of last update: 13 Jan 2025

Sources: Colorado's Secretary of State

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