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  5. CAPITAL CITY FAMILY MEDICINE, P.A.

CAPITAL CITY FAMILY MEDICINE, P.A.

Company Details

Name: CAPITAL CITY FAMILY MEDICINE, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 02 Nov 1998 (26 years ago)
Financial Date End: 30 Nov 2011
Date dissolved: 08 Feb 2012
Entity Number: 386506
Place of Formation: IDAHO
File Number: 0000386506
ZIP code: 83702
County: Ada County
Mailing Address: 1520 W STATE ST STE 100 BOISE, ID 83702

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CAPITAL CITY FAMILY MEDICINE, P.A. PROFIT SHARING PLAN 2010 820506859 2011-09-20 CAPITAL CITY FAMILY MEDICINE, P.A. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2089477708
Plan sponsor’s address 1520 W. STATE SUITE 100, BOISE, ID, 83702

Plan administrator’s name and address
Administrator’s EIN 820506859
Plan administrator’s name CAPITAL CITY FAMILY MEDICINE, P.A.
Plan administrator’s address 1520 W. STATE SUITE 100, BOISE, ID, 83702
Administrator’s telephone number 2089477708

Signature of
Role Plan administrator
Date 2011-09-20
Name of individual signing WILLIAM JONAKIN
Valid signature Filed with authorized/valid electronic signature
CAPITAL CITY FAMILY MEDICINE P.A. PROFIT SHARING PLAN 2010 820506859 2011-09-19 CAPITAL CITY FAMILY MEDICINE, P.A. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2089477708
Plan sponsor’s address 1520 W STATE SUITE 100, BOISE, ID, 83702

Plan administrator’s name and address
Administrator’s EIN 820506859
Plan administrator’s name CAPITAL CITY FAMILY MEDICINE, P.A.
Plan administrator’s address 1520 W STATE SUITE 100, BOISE, ID, 83702
Administrator’s telephone number 2089477708

Signature of
Role Plan administrator
Date 2011-09-19
Name of individual signing WILLIAM JONAKIN
Valid signature Filed with authorized/valid electronic signature
CAPITAL CITY FAMILY MEDICINE P.A. PROFIT SHARING PLAN 2010 820506859 2011-09-16 CAPITAL CITY FAMILY MEDICINE, P.A. 30
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2089477708
Plan sponsor’s address 1520 W STATE SUITE 100, BOISE, ID, 83702

Plan administrator’s name and address
Administrator’s EIN 820506859
Plan administrator’s name CAPITAL CITY FAMILY MEDICINE, P.A.
Plan administrator’s address 1520 W STATE SUITE 100, BOISE, ID, 83702
Administrator’s telephone number 2089477708

Signature of
Role Plan administrator
Date 2011-09-16
Name of individual signing WILLIAM JONAKIN
Valid signature Filed with incorrect/unrecognized electronic signature
CAPITAL CITY FAMILY MEDICINE P.A. PROFIT SHARING PLAN 2009 820506859 2010-07-22 CAPITAL CITY FAMILY MEDICINE, P.A. 29
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2089477708
Plan sponsor’s address 1520 W STATE SUITE 100, BOISE, ID, 83702

Plan administrator’s name and address
Administrator’s EIN 820506859
Plan administrator’s name CAPITAL CITY FAMILY MEDICINE, P.A.
Plan administrator’s address 1520 W STATE SUITE 100, BOISE, ID, 83702
Administrator’s telephone number 2089477708

Signature of
Role Plan administrator
Date 2010-07-22
Name of individual signing WILLIAM JONAKIN
Valid signature Filed with incorrect/unrecognized electronic signature
CAPITAL CITY FAMILY MEDICINE P.A. PROFIT SHARING PLAN 2009 820506859 2010-07-23 CAPITAL CITY FAMILY MEDICINE, P.A. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2089477708
Plan sponsor’s address 1520 W STATE SUITE 100, BOISE, ID, 83702

Plan administrator’s name and address
Administrator’s EIN 820506859
Plan administrator’s name CAPITAL CITY FAMILY MEDICINE, P.A.
Plan administrator’s address 1520 W STATE SUITE 100, BOISE, ID, 83702
Administrator’s telephone number 2089477708

Signature of
Role Plan administrator
Date 2010-07-23
Name of individual signing WILLIAM JONAKIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-23
Name of individual signing WILLIAM JONAKIN
Valid signature Filed with authorized/valid electronic signature
CAPITAL CITY FAMILY MEDICINE P.A. PROFIT SHARING PLAN 2009 820506859 2010-07-23 CAPITAL CITY FAMILY MEDICINE, P.A. 29
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2089477708
Plan sponsor’s address 1520 W STATE SUITE 100, BOISE, ID, 83702

Plan administrator’s name and address
Administrator’s EIN 820506859
Plan administrator’s name CAPITAL CITY FAMILY MEDICINE, P.A.
Plan administrator’s address 1520 W STATE SUITE 100, BOISE, ID, 83702
Administrator’s telephone number 2089477708

Signature of
Role Plan administrator
Date 2010-07-22
Name of individual signing WILLIAM JONAKIN
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-07-23
Name of individual signing WILLIAM JONAKIN
Valid signature Filed with incorrect/unrecognized electronic signature

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0002657817 2010-02-24
Application for Reinstatement 0000880323 2010-02-18
Annual Report 0002657816 2008-09-29
Annual Report 0002657815 2007-10-01
Annual Report 0002657813 2006-09-21
Annual Report 0002657812 2005-09-13
Annual Report 0002657811 2004-09-20
Annual Report 0002657810 2003-09-24
Annual Report 0002657805 2002-09-09
Annual Report 0002657819 2001-10-16

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Date of last update: 25 Sep 2024

Sources: Idaho Secretary of State

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