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NEWBROOK INSURANCE AGENCY, INC.

Company Details

Name: NEWBROOK INSURANCE AGENCY, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 11 Jan 1985 (40 years ago)
Entity Number: 965969
ZIP code: 11776
County: Suffolk
Place of Formation: New York
Address: 14 ROOSEVELT AVE., PORT JEFFERSON STATION, NY, United States, 11776
Principal Address: 14 ROOSEVELT AVE., PORT JEFFERSON STAT., NY, United States, 11776

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2023 112718154 2024-03-25 NEWBROOK INSURANCE AGENCY, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2024-03-25
Name of individual signing MICHAEL KELSON
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2022 112718154 2023-04-19 NEWBROOK INSURANCE AGENCY, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2023-04-19
Name of individual signing MICHAEL KELSON
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2021 112718154 2022-05-26 NEWBROOK INSURANCE AGENCY, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2022-05-26
Name of individual signing MICHAEL KELSON
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2020 112718154 2021-02-23 NEWBROOK INSURANCE AGENCY, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2021-02-23
Name of individual signing MICHAEL KELSON
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2019 112718154 2020-03-16 NEWBROOK INSURANCE AGENCY, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2020-03-16
Name of individual signing MICHAEL KELSON
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2018 112718154 2019-02-26 NEWBROOK INSURANCE AGENCY, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2019-02-26
Name of individual signing MICHAEL KELSON
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2017 112718154 2018-05-09 NEWBROOK INSURANCE AGENCY, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2018-05-09
Name of individual signing MICHAEL KELSON
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2016 112718154 2017-08-03 NEWBROOK INSURANCE AGENCY, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2017-08-03
Name of individual signing NEWBROOK INSURANCE AGENCY
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2015 112718154 2016-06-22 NEWBROOK INSURANCE AGENCY, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2016-06-22
Name of individual signing NEWBROOK INSURANCE AGENCY INC.
NEWBROOK INSURANCE AGENCY RETIREMENT PLAN 2014 112718154 2015-07-20 NEWBROOK INSURANCE AGENCY, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524210
Sponsor’s telephone number 6314737059
Plan sponsor’s address 14 ROOSEVELT AVENUE, PORT JEFFERSON STATION, NY, 11776

Signature of

Role Plan administrator
Date 2015-07-20
Name of individual signing MICHAEL KELSON

Chief Executive Officer

Name Role Address
DAVID LEVINE Chief Executive Officer 14 ROOSEVELT AVE., PORT JEFFERSON STAT., NY, United States, 11776

DOS Process Agent

Name Role Address
DAVID LEVINE DOS Process Agent 14 ROOSEVELT AVE., PORT JEFFERSON STATION, NY, United States, 11776

History

Start date End date Type Value
1993-02-11 2013-01-10 Address 14 ROOSEVELT AVE., PORT JEFFERSON STAT., NY, 11776, USA (Type of address: Chief Executive Officer)
1993-02-11 2013-01-10 Address 14 ROOSEVELT AVE., PORT JEFFERSON STAT., NY, 11776, USA (Type of address: Principal Executive Office)
1993-02-11 2013-01-10 Address 14 ROOSEVELT AVE., PORT JEFFERSON STATION, NY, 11776, USA (Type of address: Service of Process)
1985-01-11 1993-02-11 Address 4600 NESCONSET HIGHWAY, PORT JEFFERSON STA, NY, 11776, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
210104060832 2021-01-04 BIENNIAL STATEMENT 2021-01-01
190107060346 2019-01-07 BIENNIAL STATEMENT 2019-01-01
170104006361 2017-01-04 BIENNIAL STATEMENT 2017-01-01
130110006513 2013-01-10 BIENNIAL STATEMENT 2013-01-01
110121002960 2011-01-21 BIENNIAL STATEMENT 2011-01-01
081229002794 2008-12-29 BIENNIAL STATEMENT 2009-01-01
061226002158 2006-12-26 BIENNIAL STATEMENT 2007-01-01
050201002433 2005-02-01 BIENNIAL STATEMENT 2005-01-01
010202002744 2001-02-02 BIENNIAL STATEMENT 2001-01-01
990122002336 1999-01-22 BIENNIAL STATEMENT 1999-01-01

Date of last update: 06 Jan 2025

Sources: New York Secretary of State