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  5. KEYSTONE HEART US, INC.

KEYSTONE HEART US, INC.

Headquarter

Company Details

Entity Name: KEYSTONE HEART US, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 15 Jun 2016 (9 years ago)
Date of dissolution: 03 Jan 2024 (a year ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 03 Jan 2024 (a year ago)
Document Number: P16000051442
FEI/EIN Number 81-2959544
Address: 410 S. Cedar Avenue, Tampa, FL, 33606, US
Mail Address: 410 S. Cedar Avenue, Tampa, FL, 33606, US
ZIP code: 33606
County: Hillsborough
Place of Formation: FLORIDA

Links between entities

Type Company Name Company Number State
Headquarter of KEYSTONE HEART US, INC., COLORADO 20171070855 COLORADO

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KEYSTONE HEART US INC 401(K) PLAN 2023 812959544 2024-04-01 KEYSTONE HEART US INC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 423990
Sponsor’s telephone number 8135308200
Plan sponsor’s address 3000 BAYPORT DR. SUITE 980, TAMPA, FL, 33607

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DR, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-04-01
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
KEYSTONE HEART US INC 401(K) PLAN 2023 812959544 2024-04-01 KEYSTONE HEART US INC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 423990
Sponsor’s telephone number 8135308200
Plan sponsor’s address 3000 BAYPORT DR. SUITE 980, TAMPA, FL, 33607

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-04-01
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
KEYSTONE HEART US INC 401(K) PLAN 2022 812959544 2023-09-22 KEYSTONE HEART US INC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 423990
Sponsor’s telephone number 8135308200
Plan sponsor’s address 3000 BAYPORT DR. SUITE 980, TAMPA, FL, 33607

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DR, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-09-22
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
KEYSTONE HEART US INC 401(K) PLAN 2021 812959544 2022-12-28 KEYSTONE HEART US INC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 423990
Sponsor’s telephone number 8135308200
Plan sponsor’s address 3000 BAYPORT DR. SUITE 980, TAMPA, FL, 33607

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DR, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2022-12-28
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
KEYSTONE HEART US INC 401(K) PLAN 2021 812959544 2022-09-23 KEYSTONE HEART US INC 11
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 423990
Sponsor’s telephone number 8135308200
Plan sponsor’s address 3000 BAYPORT DR. SUITE 980, TAMPA, FL, 33607

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DR, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2022-09-23
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
KEYSTONE HEART US INC 401(K) PLAN 2020 812959544 2021-06-25 KEYSTONE HEART US INC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 423990
Sponsor’s telephone number 8135308200
Plan sponsor’s address 3000 BAYPORT DR. SUITE 980, TAMPA, FL, 33607

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DR, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-06-25
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
KEYSTONE HEART US INC 401(K) PLAN 2019 812959544 2020-08-29 KEYSTONE HEART US INC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 423990
Sponsor’s telephone number 8135308200
Plan sponsor’s address 3000 BAYPORT DR. SUITE 980, TAMPA, FL, 33607

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DR, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2020-08-29
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
KEYSTONE HEART US INC 401(K) PLAN 2018 812959544 2019-10-10 KEYSTONE HEART US INC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 541990
Sponsor’s telephone number 8133612919
Plan sponsor’s address 3000 BAYPORT DR STE 980, TAMPA, FL, 33607

Signature of
Role Plan administrator
Date 2019-10-10
Name of individual signing BRENT METZLER
Valid signature Filed with authorized/valid electronic signature
KEYSTONE HEART US INC 401(K) PLAN 2017 812959544 2018-10-09 KEYSTONE HEART US INC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 541990
Sponsor’s telephone number 8133612919
Plan sponsor’s address 3000 BAYPORT DR STE 980, TAMPA, FL, 33607

Signature of
Role Plan administrator
Date 2018-10-09
Name of individual signing BRENT METZLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
GOODWIN JAMES W Agent 201 N. Franklin Street, Suite 2000, Tampa, FL, 33602

Director

Name Role Address
Metzler Brent Director 410 S. Cedar Avenue, Tampa, FL, 33606

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2024-01-03 No data No data
CHANGE OF PRINCIPAL ADDRESS 2022-03-22 410 S. Cedar Avenue, Tampa, FL 33606 No data
CHANGE OF MAILING ADDRESS 2022-03-22 410 S. Cedar Avenue, Tampa, FL 33606 No data
REGISTERED AGENT ADDRESS CHANGED 2022-03-22 201 N. Franklin Street, Suite 2000, Tampa, FL 33602 No data

Documents

Name Date
Voluntary Dissolution 2024-01-03
ANNUAL REPORT 2023-03-16
AMENDED ANNUAL REPORT 2022-03-22
ANNUAL REPORT 2022-03-08
ANNUAL REPORT 2021-02-04
ANNUAL REPORT 2020-05-22
ANNUAL REPORT 2019-01-20
ANNUAL REPORT 2018-01-25
ANNUAL REPORT 2017-03-04
Domestic Profit 2016-06-15

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Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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