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  5. ELLSWORTH INSURANCE AGENCY, INC.

ELLSWORTH INSURANCE AGENCY, INC.

Company Details

Name: ELLSWORTH INSURANCE AGENCY, INC.
Jurisdiction: Colorado
Legal type: Domestic profit corporation
Status: Voluntarily Dissolved
Date of registration: 11 Jan 1985 (40 years ago)
Date dissolved: 31 Dec 2022
Entity Number: 19871602247
ZIP code: 80602
County: Adams County
Place of Formation: COLORADO
Principal Address: 14928 Madison St. Brighton CO 80602 US
Mailing Address: 14928 Madison St Brighton CO 80602 US

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ELLSWORTH INSURANCE AGENCY, INC. 401K PLAN 2017 840981066 2018-05-23 ELLSWORTH INSURANCE AGENCY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 524210
Sponsor’s telephone number 3039810962
Plan sponsor’s address 14928 MADISON ST., BRIGHTON, CO, 80602

Signature of
Role Plan administrator
Date 2018-05-23
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-23
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
ELLSWORTH INSURANCE AGENCY, INC. 401K PLAN 2016 840981066 2017-05-02 ELLSWORTH INSURANCE AGENCY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 524210
Sponsor’s telephone number 3034511363
Plan sponsor’s address 11160 HURON ST., SUITE 202, NORTHGLENN, CO, 80234

Signature of
Role Plan administrator
Date 2017-05-02
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
ELLSWORTH INSURANCE AGENCY, INC. 401K PLAN 2015 840981066 2016-05-10 ELLSWORTH INSURANCE AGENCY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 524210
Sponsor’s telephone number 3034511363
Plan sponsor’s address 11160 HURON ST., SUITE 202, NORTHGLENN, CO, 80234

Signature of
Role Plan administrator
Date 2016-05-10
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
ELLSWORTH INSURANCE AGENCY, INC. 401K PLAN 2014 840981066 2015-10-06 ELLSWORTH INSURANCE AGENCY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 524210
Sponsor’s telephone number 3034511363
Plan sponsor’s address 11160 HURON ST., SUITE 202, NORTHGLENN, CO, 80234

Signature of
Role Plan administrator
Date 2015-10-06
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-06
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
ELLSWORTH INSURANCE AGENCY, INC. 401K PLAN 2014 840981066 2015-04-16 ELLSWORTH INSURANCE AGENCY, INC. 2
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 524210
Sponsor’s telephone number 3034511363
Plan sponsor’s address 11160 HURON ST., SUITE 202, NORTHGLENN, CO, 80234

Signature of
Role Plan administrator
Date 2015-04-16
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-16
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
ELLSWORTH INSURANCE AGENCY, INC. 401K PLAN 2013 840981066 2014-05-13 ELLSWORTH INSURANCE AGENCY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 524210
Sponsor’s telephone number 3034511363
Plan sponsor’s address 11160 HURON ST., SUITE 202, NORTHGLENN, CO, 80234

Signature of
Role Plan administrator
Date 2014-05-13
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
ELLSWORTH INSURANCE AGENCY, INC. 401K PLAN 2012 840981066 2013-08-28 ELLSWORTH INSURANCE AGENCY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 524210
Sponsor’s telephone number 3034511363
Plan sponsor’s address 11160 HURON ST., SUITE 202, NORTHGLENN, CO, 80234

Signature of
Role Plan administrator
Date 2013-08-28
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-28
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
ELLSWORTH INSURANCE AGENCY, INC. 401K PLAN 2011 840981066 2012-03-20 ELLSWORTH INSURANCE AGENCY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 524210
Sponsor’s telephone number 3034511363
Plan sponsor’s address 11455 N. WASHINGTON, SUITE J, NORTHGLENN, CO, 80233

Plan administrator’s name and address
Administrator’s EIN 840981066
Plan administrator’s name ELLSWORTH INSURANCE AGENCY, INC.
Plan administrator’s address 11455 N. WASHINGTON, SUITE J, NORTHGLENN, CO, 80233
Administrator’s telephone number 3034511363

Signature of
Role Plan administrator
Date 2012-03-20
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
ELLSWORTH INSURANCE AGENCY, INC. 401K PLAN 2010 840981066 2011-05-24 ELLSWORTH INSURANCE AGENCY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 524210
Sponsor’s telephone number 3034511363
Plan sponsor’s address 11455 N. WASHINGTON, SUITE J, THORNTON, CO, 80233

Plan administrator’s name and address
Administrator’s EIN 840981066
Plan administrator’s name ELLSWORTH INSURANCE AGENCY, INC.
Plan administrator’s address 11455 N. WASHINGTON, SUITE J, THORNTON, CO, 80233
Administrator’s telephone number 3034511363

Signature of
Role Plan administrator
Date 2011-05-24
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-24
Name of individual signing MIKE ELLSWORTH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MICHAEL ELLSWORTH Agent 14928 Madison St. Brighton CO 80602 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20228209643 Dissolve a Profit Corporation 2022-12-12 2022-12-31 ELLSWORTH INSURANCE AGENCY, INC., Dissolved December 31, 2022 No data
20218203721 File Report 2021-12-24 2021-12-24 No data No data
20208095652 File Report 2020-12-23 2020-12-23 No data No data
20198025353 File Report 2019-12-23 2019-12-23 No data No data
20188019083 File Report 2018-12-24 2018-12-24 No data No data
20171949669 File Report 2017-12-26 2017-12-26 No data No data
20161873136 File Report 2016-12-27 2016-12-27 No data Change of Registered Agent Address / Change of Entity Address
20151813723 File Report 2015-12-23 2015-12-23 No data No data
20141772788 File Report 2014-12-23 2014-12-23 No data No data
20131737694 File Report 2013-12-26 2013-12-26 No data Change of Registered Agent Address / Change of Entity Address

Related by officers

MICHAEL ELLSWORTH

1ST COLORADO INSURORS, INC.

Related by address

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Date of last update: 23 Dec 2024

Sources: Colorado's Secretary of State

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