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  5. Nick Gustafson Insurance Agency Inc

Nick Gustafson Insurance Agency Inc

Company Details

Name: Nick Gustafson Insurance Agency Inc
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Good Standing
Date of registration: 30 Oct 2015 (9 years ago)
Entity Number: 20151706802
ZIP code: 80112
County: Arapahoe County
Place of Formation: COLORADO
Principal Address: 7200 S Alton Way Ste B130 Centennial CO 80112 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NICK GUSTAFSON INSURANCE AGENCY401K 2023 475504919 2024-05-23 NICK GUSTAFSON INSURANCE AGENCY INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 524290
Sponsor’s telephone number 7209333387
Plan sponsor’s address 68 INVERNESS LN E STE 203, ENGLEWOOD, CO, 80112

Signature of
Role Plan administrator
Date 2024-05-23
Name of individual signing NICK GUSTAFSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-23
Name of individual signing NICK GUSTAFSON
Valid signature Filed with authorized/valid electronic signature
NICK GUSTAFSON INSURANCE AGENCY INC 401(K) P/S PLAN 2022 475504919 2023-04-15 NICK GUSTAFSON INSURANCE AGENCY INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 524290
Sponsor’s telephone number 7209333387
Plan sponsor’s address 68 INVERNESS LN E STE 203, ENGLEWOOD, CO, 80112

Plan administrator’s name and address
Administrator’s EIN 475504919
Plan administrator’s name NICK GUSTAFSON INSURANCE AGENCY INC
Plan administrator’s address 68 INVERNESS LN E STE 203, ENGLEWOOD, CO, 80112
Administrator’s telephone number 7209333387

Signature of
Role Plan administrator
Date 2023-04-15
Name of individual signing NICK GUSTAFSON
Valid signature Filed with authorized/valid electronic signature
NICK GUSTAFSON INSURANCE AGENCY INC 401(K) P/S PLAN 2021 475504919 2022-05-03 NICK GUSTAFSON INSURANCE AGENCY INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 524290
Sponsor’s telephone number 7209333387
Plan sponsor’s address 68 INVERNESS LN E STE 203, ENGLEWOOD, CO, 80112

Plan administrator’s name and address
Administrator’s EIN 475504919
Plan administrator’s name NICK GUSTAFSON INSURANCE AGENCY INC
Plan administrator’s address 68 INVERNESS LN E STE 203, ENGLEWOOD, CO, 80112
Administrator’s telephone number 7209333387

Signature of
Role Plan administrator
Date 2022-05-03
Name of individual signing NICK GUSTAFSON
Valid signature Filed with authorized/valid electronic signature
NICK GUSTAFSON INSURANCE AGENCY INC 401(K) P/S PLAN 2020 475504919 2021-03-15 NICK GUSTAFSON INSURANCE AGENCY INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 524290
Sponsor’s telephone number 7209333387
Plan sponsor’s address 68 INVERNESS LN E STE 203, ENGLEWOOD, CO, 80112

Plan administrator’s name and address
Administrator’s EIN 475504919
Plan administrator’s name NICK GUSTAFSON INSURANCE AGENCY INC
Plan administrator’s address 68 INVERNESS LN E STE 203, ENGLEWOOD, CO, 80112
Administrator’s telephone number 7209333387

Signature of
Role Plan administrator
Date 2021-03-15
Name of individual signing NICK GUSTAFSON
Valid signature Filed with authorized/valid electronic signature
NICK GUSTAFSON INSURANCE AGENCY INC 401(K) P/S PLAN 2019 475504919 2020-06-08 NICK GUSTAFSON INSURANCE AGENCY INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 524290
Sponsor’s telephone number 7209333387
Plan sponsor’s address 68 INVERNESS LN E STE 203, ENGLEWOOD, CO, 80112

Plan administrator’s name and address
Administrator’s EIN 475504919
Plan administrator’s name NICK GUSTAFSON INSURANCE AGENCY INC
Plan administrator’s address 68 INVERNESS LN E STE 203, ENGLEWOOD, CO, 80112
Administrator’s telephone number 7209333387

Signature of
Role Plan administrator
Date 2020-06-08
Name of individual signing NICK GUSTAFSON
Valid signature Filed with authorized/valid electronic signature
NICK GUSTAFSON INSURANCE AGENCY INC 401(K) P/S PLAN 2018 475504919 2019-04-01 NICK GUSTAFSON INSURANCE AGENCY INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 524290
Sponsor’s telephone number 7209333387
Plan sponsor’s address 9362 TEDDY LN STE 106, LONE TREE, CO, 80124

Plan administrator’s name and address
Administrator’s EIN 475504919
Plan administrator’s name NICK GUSTAFSON INSURANCE AGENCY INC
Plan administrator’s address 9362 TEDDY LN STE 106, LONE TREE, CO, 80124
Administrator’s telephone number 7209333387

Signature of
Role Plan administrator
Date 2019-04-01
Name of individual signing NICK GUSTAFSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Nick Anthony Gustafson Agent 3850 County Road 166 Elizabeth CO 80107 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20248006331 File Report 2024-09-23 2024-09-23 No data Principal address changed, Change in registered agent information
20231982040 File Report 2023-09-24 2023-09-24 No data Principal address changed, Change in registered agent information
20221913741 File Report 2022-09-23 2022-09-23 No data Change in registered agent information
20211869701 File Report 2021-09-23 2021-09-23 No data Change of Entity Address
20201817427 File Report 2020-09-23 2020-09-23 No data No data
20191751082 File Report 2019-09-23 2019-09-23 No data Change of Registered Agent Address
20181751085 File Report 2018-09-24 2018-09-24 No data Change of Entity Address
20181075985 Statement of Change Changing the Registered Agent Information 2018-01-25 2018-01-25 No data Registered agent information changed;
20171721192 File Report 2017-09-25 2017-09-25 No data Change of Entity Address
20161657485 File Report 2016-09-27 2016-09-27 No data Change of Entity Address

Related by officers

Nick Anthony Gustafson

The Gus Group LLC

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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