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  5. APPLEGATE ORTHOPEDIC SPINE CENTER, P.C.

APPLEGATE ORTHOPEDIC SPINE CENTER, P.C.

Company Details

Entity Name: APPLEGATE ORTHOPEDIC SPINE CENTER, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Dissolved
Sub status: Annual report past due
Date Formed: 22 May 2008
Date of dissolution: 29 Feb 2024
Business ALEI: 0939043
Annual report due: 22 May 2023
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 5 PEQUOT PARK RD, SUITE 201A, WESTBROOK, CT, 06498, United States
Mailing address: 5 PEQUOT PARK RD, SUITE 201A, WESTBROOK, CT, United States, 06498
ZIP code: 06498
County: Middlesex
Place of Formation: CONNECTICUT
Total authorized shares: 1000
E-Mail: tda7pine@gmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
APPLEGATE ORTHOPEDIC SPINE CENTER 401(K) PLAN 2016 611562999 2017-07-18 APPLEGATE ORTHOPEDIC SPINE CENTER P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 8603918068
Plan sponsor’s address 5 PEQUOT PARK ROAD, SUITE 201A, WESTBROOK, CT, 06498

Signature of
Role Plan administrator
Date 2017-07-18
Name of individual signing TODD APPLEGATE
Valid signature Filed with authorized/valid electronic signature
APPLEGATE ORTHOPEDIC SPINE CENTER 401(K) PLAN 2014 611562999 2015-08-20 APPLEGATE ORTHOPEDIC SPINE CENTER, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 8603918068
Plan sponsor’s address 5 PEQUOT PARK ROAD, SUITE 201A, WESTBROOK, CT, 06498

Signature of
Role Plan administrator
Date 2015-08-20
Name of individual signing TODD APPLEGATE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-08-20
Name of individual signing TODD APPLEGATE
Valid signature Filed with authorized/valid electronic signature
APPLEGATE ORTHOPEDIC SPINE CENTER 401(K) PLAN 2013 611562999 2014-07-08 APPLEGATE ORTHOPEDIC SPINE CENTER, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 8603918068
Plan sponsor’s address 5 PEQUOT PARK ROAD, SUITE 201A, WESTBROOK, CT, 06498

Signature of
Role Plan administrator
Date 2014-07-08
Name of individual signing TODD D. APPLEGATE D.O
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-08
Name of individual signing TODD D. APPLEGATE D.O
Valid signature Filed with authorized/valid electronic signature
APPLEGATE ORTHOPEDIC SPINE CENTER 401(K) PLAN 2012 611562999 2013-06-24 APPLEGATE ORTHOPEDIC SPINE CENTER, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 8603918068
Plan sponsor’s address 5 PEQUOT PARK ROAD, SUITE 201A, WESTBROOK, CT, 06498

Signature of
Role Plan administrator
Date 2013-06-24
Name of individual signing TODD APPLEGATE
Valid signature Filed with authorized/valid electronic signature
APPLEGATE ORTHOPEDIC SPINE CENTER 401(K) PLAN 2011 611562999 2012-05-01 APPLEGATE ORTHOPEDIC SPINE CENTER, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 8603918068
Plan sponsor’s address 5 PEQUOT PARK RD, SUITE 201A, WESTBROOK, CT, 06498

Plan administrator’s name and address
Administrator’s EIN 611562999
Plan administrator’s name APPLEGATE ORTHOPEDIC SPINE CENTER, P.C.
Plan administrator’s address 5 PEQUOT PARK RD, SUITE 201A, WESTBROOK, CT, 06498
Administrator’s telephone number 8603918068

Signature of
Role Plan administrator
Date 2012-05-01
Name of individual signing TODD APPLEGATE
Valid signature Filed with authorized/valid electronic signature
APPLEGATE ORTHOPEDIC SPINE CENTER 401(K) PLAN 2010 611562999 2011-05-11 APPLEGATE ORTHOPEDIC SPINE CENTER, P.C 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 8607672004
Plan sponsor’s address 12 BOKUM RD, SUITE C, ESSEX, CT, 06426

Plan administrator’s name and address
Administrator’s EIN 611562999
Plan administrator’s name APPLEGATE ORTHOPEDIC SPINE CENTER, P.C
Plan administrator’s address 12 BOKUM RD, SUITE C, ESSEX, CT, 06426
Administrator’s telephone number 8607672004

Signature of
Role Plan administrator
Date 2011-05-11
Name of individual signing TODD D APPLEGATE
Valid signature Filed with authorized/valid electronic signature
APPLEGATE ORTHOPEDIC SPINE CENTER 401(K) PLAN 2009 611562999 2010-11-05 APPLEGATE ORTHOPEDIC SPINE CENTER, 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 8607672004
Plan sponsor’s address 12 BOKUM RD, ESSEX, CT, 06426

Plan administrator’s name and address
Administrator’s EIN 611562999
Plan administrator’s name APPLEGATE ORTHOPEDIC SPINE CENTER,
Plan administrator’s address 12 BOKUM RD, ESSEX, CT, 06426
Administrator’s telephone number 8607672004

Signature of
Role Plan administrator
Date 2010-11-05
Name of individual signing TODD D APPLEGATE DO
Valid signature Filed with authorized/valid electronic signature
APPLEGATE ORTHOPEDIC SPINE CENTER 401(K) PLAN 2009 611562999 2010-11-04 APPLEGATE ORTHOPEDIC SPINE CENTER, 3
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 8607672004
Plan sponsor’s address 12 BOKUM RD, ESSEX, CT, 06426

Plan administrator’s name and address
Administrator’s EIN 611562999
Plan administrator’s name APPLEGATE ORTHOPEDIC SPINE CENTER,
Plan administrator’s address 12 BOKUM RD, ESSEX, CT, 06426
Administrator’s telephone number 8607672004

Signature of
Role Employer/plan sponsor
Date 2010-11-04
Name of individual signing TODD D APPLEGATE DO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
TODD D. APPLEGATE Agent 5 PEQUOT PARK RD, SUITE 201A, WESTBROOK, CT, 06498, United States 5 PEQUOT PARK RD, SUITE 201A, WESTBROOK, CT, 06498, United States +1 860-575-7097 tda7pine@gmail.com 75 HAMMONASETT MEADOWS, MADISON, CT, 06443, United States

Director

Name Role Business address Phone E-Mail Residence address
TODD D. APPLEGATE Director 5 PEQUOT PARK RD, SUITE 201A, WESTBROOK, CT, 06498, United States +1 860-575-7097 tda7pine@gmail.com 75 HAMMONASETT MEADOWS, MADISON, CT, 06443, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012572804 2024-02-29 2024-02-29 Dissolution Certificate of Dissolution No data
BF-0010281868 2022-04-27 No data Annual Report Annual Report 2022
BF-0009757288 2021-09-01 No data Annual Report Annual Report No data
0006916832 2020-06-03 No data Annual Report Annual Report 2020
0006542282 2019-04-25 No data Annual Report Annual Report 2019
0006427626 2019-03-06 No data Annual Report Annual Report 2018
0006179512 2018-05-08 No data Annual Report Annual Report 2017
0005837221 2017-05-08 No data Annual Report Annual Report 2016
0005570026 2016-05-20 No data Annual Report Annual Report 2015
0005091954 2014-04-24 No data Annual Report Annual Report 2014

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Date of last update: 20 Jan 2025

Sources: Connecticut's Official State Website

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