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  5. POLICYGENIUS INC.

POLICYGENIUS INC.

Company Details

Name: POLICYGENIUS INC.
Jurisdiction: New York
Legal type: FOREIGN BUSINESS CORPORATION
Status: Inactive
Date of registration: 18 Mar 2013 (12 years ago)
Date of dissolution: 08 Nov 2023
Entity Number: 4375292
ZIP code: 12205
County: New York
Place of Formation: Delaware
Address: 187 WOLF ROAD, SUITE 101, ALBANY, NY, United States, 12205
Principal Address: 32 Old Slip, Floor 30, NEW YORK, NY, United States, 10005

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
POLICYGENIUS, INC. EMPLOYEE BENEFITS PLAN 2021 461553649 2022-10-06 POLICYGENIUS, INC. 522
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2019-01-01
Business code 524290
Sponsor’s telephone number 7036009245
Plan sponsor’s mailing address 32 OLD SLIP, 30TH FLOOR, NEW YORK, NY, 10005
Plan sponsor’s address 32 OLD SLIP, 30TH FLOOR, NEW YORK, NY, 10005

Number of participants as of the end of the plan year
Active participants 775

Signature of
Role Plan administrator
Date 2022-10-06
Name of individual signing DAVID SANDLER
Valid signature Filed with authorized/valid electronic signature
POLICYGENIUS, INC. EMPLOYEE BENEFITS PLAN 2020 461553649 2021-07-16 POLICYGENIUS, INC. 232
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2019-01-01
Business code 524290
Sponsor’s telephone number 7036009245
Plan sponsor’s mailing address 50 WEST 23RD STREET, NEW YORK, NY, 10010
Plan sponsor’s address 50 WEST 23RD STREET, NEW YORK, NY, 10010

Number of participants as of the end of the plan year
Active participants 522

Signature of
Role Plan administrator
Date 2021-07-15
Name of individual signing DAVID SANDLER
Valid signature Filed with authorized/valid electronic signature
POLICYGENIUS, INC. EMPLOYEE BENEFITS PLAN 2019 461553649 2020-07-28 POLICYGENIUS, INC. 148
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2019-01-01
Business code 524290
Sponsor’s telephone number 7036009245
Plan sponsor’s mailing address 50 WEST 23RD STREET, NEW YORK, NY, 10010
Plan sponsor’s address 50 WEST 23RD STREET, NEW YORK, NY, 10010

Number of participants as of the end of the plan year
Active participants 232

Signature of
Role Plan administrator
Date 2020-07-28
Name of individual signing DAVID SANDLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-28
Name of individual signing DAVID SANDLER
Valid signature Filed with authorized/valid electronic signature
FORUS 401(K) 2018 461553649 2019-07-07 POLICYGENIUS, INC. 101
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-11-01
Business code 524290
Sponsor’s telephone number 7036009245
Plan sponsor’s address 240 KENT AVENUE, K2-B12, BROOKLYN, NY, 11249

Plan administrator’s name and address
Administrator’s EIN 464315488
Plan administrator’s name 3(16) FIDUCIARY SOLUTIONS, INC.
Plan administrator’s address 878 W AIRPORT ROAD, MENASHA, WI, 54952
Administrator’s telephone number 9205605698

Signature of
Role Plan administrator
Date 2019-07-07
Name of individual signing CHRISTOPHER DIERINGER
FORUS 401(K) 2017 461553649 2018-06-24 POLICYGENIUS, INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-11-01
Business code 524290
Sponsor’s telephone number 7036009245
Plan sponsor’s address 240 KENT AVENUE, K2-B12, BROOKLYN, NY, 11249

Plan administrator’s name and address
Administrator’s EIN 464315488
Plan administrator’s name 3(16) FIDUCIARY SOLUTIONS, INC.
Plan administrator’s address 878 W AIRPORT ROAD, MENASHA, WI, 54952
Administrator’s telephone number 9205205698

Signature of
Role Plan administrator
Date 2018-06-24
Name of individual signing CHRISTOPHER DIERINGER
FORUS 401(K) 2016 461553649 2017-07-01 POLICYGENIUS, INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-11-01
Business code 524290
Sponsor’s telephone number 7036009245
Plan sponsor’s address 240 KENT AVENUE, K2-B12, BROOKLYN, NY, 11249

Plan administrator’s name and address
Administrator’s EIN 464315488
Plan administrator’s name 3(16) FIDUCIARY SOLUTIONS, INC.
Plan administrator’s address 878 W AIRPORT ROAD, MENASHA, WI, 54952
Administrator’s telephone number 9205205698

Signature of
Role Plan administrator
Date 2017-07-01
Name of individual signing CHRISTOPHER DIERINGER
FORUS 401(K) 2016 461553649 2017-06-21 POLICYGENIUS, INC. 0
Three-digit plan number (PN) 001
Effective date of plan 2014-11-01
Business code 524290
Sponsor’s telephone number 7036009245
Plan sponsor’s address 240 KENT AVENUE, K2-B12, BROOKLYN, NY, 11249

Plan administrator’s name and address
Administrator’s EIN 464315488
Plan administrator’s name 3(16) FIDUCIARY SOLUTIONS, INC.
Plan administrator’s address 1920 E. NORTHLAND AVE., APPLETON, WI, 54911
Administrator’s telephone number 9205205698

Signature of
Role Plan administrator
Date 2017-06-21
Name of individual signing CHRISTOPHER DIERINGER

DOS Process Agent

Name Role Address
BUSINESS FILINGS INCORPORATED DOS Process Agent 187 WOLF ROAD, SUITE 101, ALBANY, NY, United States, 12205

Agent

Name Role
Registered Agent Revoked Agent

Chief Executive Officer

Name Role Address
JENNIFER FITZGERALD Chief Executive Officer 32 OLD SLIP, FLOOR 30, NEW YORK, NY, United States, 10005

History

Start date End date Type Value
2023-11-08 2023-11-08 Address 32 OLD SLIP, FLOOR 30, NEW YORK, NY, 10005, USA (Type of address: Chief Executive Officer)
2023-11-08 2023-11-08 Address 50 WEST 23RD, FLOOR 9, FLOOR 9, NEW YORK, NY, 10010, USA (Type of address: Chief Executive Officer)
2023-04-25 2023-11-08 Address 187 WOLF ROAD, SUITE 101, ALBANY, NY, 12205, USA (Type of address: Service of Process)
2023-04-25 2023-11-08 Address 50 WEST 23RD, FLOOR 9, FLOOR 9, NEW YORK, NY, 10010, USA (Type of address: Chief Executive Officer)
2023-04-25 2023-04-25 Address 50 WEST 23RD, FLOOR 9, FLOOR 9, NEW YORK, NY, 10010, USA (Type of address: Chief Executive Officer)
2023-04-25 2023-11-08 Address 32 OLD SLIP, FLOOR 30, NEW YORK, NY, 10005, USA (Type of address: Chief Executive Officer)
2023-04-25 2023-04-25 Address 32 OLD SLIP, FLOOR 30, NEW YORK, NY, 10005, USA (Type of address: Chief Executive Officer)
2023-04-25 2023-11-08 Address 187 WOLF ROAD, SUITE 101, ALBANY, NY, 12205, USA (Type of address: Registered Agent)
2021-12-27 2023-04-25 Address 187 WOLF ROAD, SUITE 101, ALBANY, NY, 12205, USA (Type of address: Service of Process)
2021-12-27 2023-04-25 Address 32 OLD SLIP, FLOOR 30, NEW YORK, NY, 10005, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
231108003786 2023-11-08 CERTIFICATE OF TERMINATION 2023-11-08
230425003673 2023-04-25 BIENNIAL STATEMENT 2023-03-01
211227001810 2021-12-23 AMENDMENT TO BIENNIAL STATEMENT 2021-12-23
211028000373 2021-10-27 CERTIFICATE OF CHANGE BY ENTITY 2021-10-27
210304060076 2021-03-04 BIENNIAL STATEMENT 2021-03-01
190308060721 2019-03-08 BIENNIAL STATEMENT 2019-03-01
180524006001 2018-05-24 BIENNIAL STATEMENT 2017-03-01
150325006190 2015-03-25 BIENNIAL STATEMENT 2015-03-01
140123000579 2014-01-23 CERTIFICATE OF AMENDMENT 2014-01-23
130318000321 2013-03-18 APPLICATION OF AUTHORITY 2013-03-18

Related by officers

BUSINESS FILINGS INCORPORATED

(MONTANA) ARS RECOVERY SERVICES, LLC ...IT'S YOUR DESTINY REAL ESTATE GROUP LLC 1/0 HOLDCO, LLC 10 BEAUMONT DRIVE LLC 10 LAWRENCE LLC 10 MITZVOT INT'L LLC 10 PINE RD LLC 100 MANNER'S INC 101 HAWKINS LLC

Registered Agent Revoked

#GOBEYOND LABS LLC 1 BARNES ROAD, LLC 10 UNION AVENUE LYNBROOK LLC FORTISTAR METHANE GROUP LLC 10-12 GOTHAM AVENUE, L.L.C. USBOND REALTY LLC 100 SOUTH ST 2007 LLC THE VOYA PROPRIETARY ALPHA FUND, LLC AMERICANO BARBER SHOPPE AND SPA LLC 101 H 2040 WHITE PLAINS 2 LLC

JENNIFER FITZGERALD

LAKE TO LAKE REAL ESTATE, INC.

Related by address

187 WOLF ROAD, SUITE 101, ALBANY, NY, United States, 12205

...IT'S YOUR DESTINY REAL ESTATE GROUP LLC 10 LAWRENCE LLC 1000 DETAIL SHOP CORP 101 HAWKINS LLC 102 OPERATING LLC 104 ERC DEVELOPMENT LLC 1055 HERKIMER LLC 106 FOURTH AVENUE LLC 109 LARK STREET LLC 109 WILLOW LLC

Date of last update: 25 Nov 2024

Sources: New York Secretary of State

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