Form Energy, Inc.

Somerville, MA

Massachusetts

Registered In

10/03/2017

Incorp. Date

Foreign

Registration Type

Delaware

Foreign Jurisdiction

Company Summary

Form Energy, Inc. at 30 Dane St, Somerville, Ma 02143 lists Mateo Jaramillo and Theodore Wiley as associates.

Theodore A. Wiley Registered Agent	30 DANE ST, SOMERVILLE, MA 02143 (View Past Addresses)
Mateo Jaramillo CEO
Theodore Wiley President
Philip Deutch Director
Mateo Jaramillo Director
Theodore Wiley Director
Marc Mezvinsky Director
Fabien Duclocher Director
Gabriel Kra Director
Michael Skelly Director

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30 DANE ST, SOMERVILLE, MA 02143 View Map

Form 5500

30 Dane Street, Somerville, Ma 02143 (884) 367-6462 EIN:82-2266384 Plan Admin:Elizabeth Codner

Year	Plan Name	Participants BOY/EOY	Assets BOY/EOY
2023	Plan NameFORM ENERGY, INC. HEALTH AND WELFARE BENEFIT PLAN Plan #501 Participants BOY/EOY373 / 0 Assets BOY/EOY$0 / $0	2023	FORM ENERGY, INC. HEALTH AND WELFARE BENEFIT PLAN - Plan #501	373 / 0	$0 / $0
2022	Plan NameFORM ENERGY INC. 401(K) PLAN Plan #001 Participants BOY/EOY217 / 442 Assets BOY/EOY$5,174,588 / $8,407,481	2022	FORM ENERGY INC. 401(K) PLAN - Plan #001	217 / 442	$5,174,588 / $8,407,481
2022	Plan NameFORM ENERGY, INC. HEALTH AND WELFARE BENEFIT PLAN Plan #501 Participants BOY/EOY174 / 0 Assets BOY/EOY$0 / $0	2022	FORM ENERGY, INC. HEALTH AND WELFARE BENEFIT PLAN - Plan #501	174 / 0	$0 / $0
2021	Plan NameFORM ENERGY INC. 401(K) PLAN Plan #001 Participants BOY/EOY94 / 223 Assets BOY/EOY$1,673,718 / $5,174,588	2021	FORM ENERGY INC. 401(K) PLAN - Plan #001	94 / 223	$1,673,718 / $5,174,588
2020	Plan NameFORM ENERGY INC. 401(K) PLAN Plan #001 Participants BOY/EOY68 / 94 Assets BOY/EOY$748,495 / $1,673,718	2020	FORM ENERGY INC. 401(K) PLAN - Plan #001	68 / 94	$748,495 / $1,673,718
2019	Plan NameFORM ENERGY INC. 401(K) PLAN Plan #001 Participants BOY/EOY31 / 68 Assets BOY/EOY$288,532 / $748,495	2019	FORM ENERGY INC. 401(K) PLAN - Plan #001	31 / 68	$288,532 / $748,495

Benefit & Retirement Plans based on Form 5500.

Related Business Names:

Form Energy, Inc. Registered in West Virginia	Charleston, WV Somerville, MA	View Report
Form Energy Inc Registered in Pennsylvania	Eighty Four, PA	View Report
Form Energy, Inc. Registered in California	Somerville, MA	View Report
Energy Form, Inc. Registered in Tennessee	Franklin, TN Nashville, TN	View Report

Address Match:30 Dane St Somerville, MA

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Vox Mobile, LLC Registered in Massachusetts	Somerville, MA	View Report

The following government agencies have contributed data:

Secretary of the Commonwealth of Massachusetts U.S. Department of Labor

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