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  5. CLOVERLEAF FAMILY MEDICINE, LLC

CLOVERLEAF FAMILY MEDICINE, LLC

Company Details

Entity Name: CLOVERLEAF FAMILY MEDICINE, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Dissolved
Date Formed: 26 May 1995
Date of dissolution: 10 Oct 2019
Business ALEI: 0516085
Business address: 1064 EAST MAIN ST., MERIDEN, CT, 06450
ZIP code: 06450
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: cloverleaf@sbcglobal.net

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2018 061428129 2019-09-30 CLOVERLEAF FAMILY MEDICINE. LLC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2017 061428129 2018-07-31 CLOVERLEAF FAMILY MEDICINE. LLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2016 061428129 2017-09-26 CLOVERLEAF FAMILY MEDICINE. LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2015 061428129 2017-09-26 CLOVERLEAF FAMILY MEDICINE. LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2014 061428129 2015-09-29 CLOVERLEAF FAMILY MEDICINE. LLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636

Signature of
Role Plan administrator
Date 2015-09-29
Name of individual signing MICHAEL KELLOGG
Valid signature Filed with authorized/valid electronic signature
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2013 061428129 2014-07-30 CLOVERLEAF FAMILY MEDICINE. LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636

Signature of
Role Plan administrator
Date 2014-07-30
Name of individual signing MICHAEL KELLOGG
Valid signature Filed with authorized/valid electronic signature
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2012 061428129 2013-10-15 CLOVERLEAF FAMILY MEDICINE. LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing MICHAEL KELLOGG
Valid signature Filed with authorized/valid electronic signature
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2011 061428129 2012-07-31 CLOVERLEAF FAMILY MEDICINE. LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636

Signature of
Role Plan administrator
Date 2012-07-31
Name of individual signing MICHAEL KELLOGG
Valid signature Filed with authorized/valid electronic signature
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2010 061428129 2011-06-14 CLOVERLEAF FAMILY MEDICINE. LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636

Signature of
Role Plan administrator
Date 2011-06-14
Name of individual signing MICHAEL KELLOGG
Valid signature Filed with authorized/valid electronic signature
CLOVERLEAF FAMILY MEDICINE. LLC 401(K) PROFIT SHARING PLAN 2009 061428129 2010-07-29 CLOVERLEAF FAMILY MEDICINE. LLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036343636
Plan sponsor’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450

Plan administrator’s name and address
Administrator’s EIN 061428129
Plan administrator’s name CLOVERLEAF FAMILY MEDICINE. LLC
Plan administrator’s address 1064 EAST MAIN STREET SUITE 301, MERIDEN, CT, 06450
Administrator’s telephone number 2036343636

Signature of
Role Plan administrator
Date 2010-07-29
Name of individual signing MICHAEL KELLOGG
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Residence address
PHILIP C. REED Agent 163 SOUTH MAIN STREET, CHESHIRE, CT, 06410, United States 424 MATTHEWS ST, PROSPECT, CT, 06712, United States

Officer

Name Role Business address Residence address
MICHAEL F. KELLOGG Officer 1064 EAST MAIN ST, MERIDEN, CT, 06450, United States 166 LANYON DR, CHESHIRE, CT, 06410, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0006661613 2019-10-10 2019-10-10 Dissolution Certificate of Dissolution No data
0006041218 2018-01-29 No data Annual Report Annual Report 2018
0005850540 2017-05-25 No data Annual Report Annual Report 2017
0005850536 2017-05-25 No data Annual Report Annual Report 2015
0005850538 2017-05-25 No data Annual Report Annual Report 2016
0005095229 2014-04-28 No data Annual Report Annual Report 2014
0004908487 2013-07-26 No data Annual Report Annual Report 2010
0004908494 2013-07-26 No data Annual Report Annual Report 2013
0004908480 2013-07-26 No data Annual Report Annual Report 2008
0004908492 2013-07-26 No data Annual Report Annual Report 2012

Related by officers

PHILIP C. REED

NORBACK BUILDERS, INC. PROSPECT PRINTING, LLC TRISTAR ENTERPRISES, LLC THE PROSPECT SOFTBALL ASSOCIATION, INC. PROSPECT INDOOR SOCCER ASSOCIATION, INC. CREATIVE PLANTSCAPES, INC. CONNECTICUT REALTY, INC. AMERICAN PSYCHOLOGICAL SERVICES, INC. CONCRETE SOLUTIONS, INC. PEKAHOPS COMPANY, INCORPORATED

Related by address

No related companies by address

Date of last update: 06 Jan 2025

Sources: Connecticut's Official State Website

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