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CLAIM SERVICES INTERNATIONAL, INC.

Company Details

Entity Name: CLAIM SERVICES INTERNATIONAL, INC.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Dissolved
Sub status: Annual report past due
Date Formed: 17 Aug 2005
Date of dissolution: 17 Feb 2023
Business ALEI: 0831024
Annual report due: 17 Aug 2023
NAICS code: 813990 - Other Similar Organizations (except Business, Professional, Labor, and Political Organizations)
Business address: 2331 State Route 17K, Montgomery, NY, 12549, United States
Mailing address: 1 Hardy Road, Ste 319, Bedford, NH, United States, 03110
Place of Formation: CONNECTICUT
Total authorized shares: 20000
E-Mail: cbcarvalho@us-csi.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLAIM SERVICES INTERNATIONAL, INC. 401(K) PLAN 2020 061278143 2021-06-28 CLAIM SERVICES INTERNATIONAL, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Signature of
Role Plan administrator
Date 2021-06-28
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature
CLAIM SERVICES INTERNATIONAL, INC. 401(K) PLAN 2019 061278143 2020-06-19 CLAIM SERVICES INTERNATIONAL, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Signature of
Role Plan administrator
Date 2020-06-19
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature
CLAIM SERVICES INTERNATIONAL, INC. 401(K) PLAN 2018 061278143 2019-04-29 CLAIM SERVICES INTERNATIONAL, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Signature of
Role Plan administrator
Date 2019-04-29
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature
CLAIM SERVICES INTERNATIONAL, INC. 401(K) PLAN 2017 061278143 2018-03-29 CLAIM SERVICES INTERNATIONAL, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Signature of
Role Plan administrator
Date 2018-03-29
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature
CLAIM SERVICES INTERNATIONAL, INC. 401(K) PLAN 2016 061278143 2017-10-06 CLAIM SERVICES INTERNATIONAL, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Signature of
Role Plan administrator
Date 2017-10-06
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature
CLAIM SERVICES INTERNATIONAL, INC. 401(K) PLAN 2015 061278143 2016-07-31 CLAIM SERVICES INTERNATIONAL, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Signature of
Role Plan administrator
Date 2016-07-31
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature
CLAIM SERVICES INTERNATIONAL, INC. 401(K) PLAN 2014 061278143 2015-07-06 CLAIM SERVICES INTERNATIONAL, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Signature of
Role Plan administrator
Date 2015-07-06
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature
CLAIM SERVICES INTERNATIONAL, INC. 401(K) PLAN 2013 061278143 2014-04-23 CLAIM SERVICES INTERNATIONAL, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Signature of
Role Plan administrator
Date 2014-04-23
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature
CLAIM SERVICES INTERNATIONAL, INC. 401(K) PLAN 2012 061278143 2013-02-20 CLAIM SERVICES INTERNATIONAL, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Signature of
Role Plan administrator
Date 2013-02-20
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature
CLAIM SERVICES INTERNATIONAL, INC 401(K) PLAN 2011 061278143 2012-09-12 CLAIM SERVICES INTERNATIONAL, INC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 524290
Sponsor’s telephone number 2037927775
Plan sponsor’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811

Plan administrator’s name and address
Administrator’s EIN 061278143
Plan administrator’s name CLAIM SERVICES INTERNATIONAL, INC
Plan administrator’s address 26 MILL PLAIN ROAD, DANBURY, CT, 06811
Administrator’s telephone number 2037927775

Signature of
Role Plan administrator
Date 2012-09-12
Name of individual signing CRYSTAL B. CARVALHO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
PINNEY PAYNE, P.C. Agent

Officer

Name Role Business address Residence address
CRYSTAL B. CARVALHO Officer 1 Hardy Road, Ste 319, Bedford, NH, 03110, United States 55 Hawk Dr, Bedford, NH, 03110-4805, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0011704408 2023-02-17 2023-02-17 Dissolution Certificate of Dissolution No data
BF-0010403569 2022-08-18 No data Annual Report Annual Report 2022
BF-0009807315 2021-09-20 No data Annual Report Annual Report No data
0007235731 2021-03-16 No data Annual Report Annual Report 2020
0006949498 2020-07-20 No data Annual Report Annual Report 2019
0006598425 2019-07-17 No data Annual Report Annual Report 2018
0006218006 2018-07-18 No data Annual Report Annual Report 2017
0005960998 2017-11-06 No data Annual Report Annual Report 2016
0005960993 2017-11-06 No data Annual Report Annual Report 2015
0005368572 2015-07-21 No data Annual Report Annual Report 2013

Related by officers

CRYSTAL B. CARVALHO

CBC ASSOCIATES, INC.

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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