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State of ConnecticutAnnual Report of Longer Care Facility Cost Year 2021 Name of Facility (as licensed) Carriage Manor, LLC Address (No. & Street, City, State, Zip Code) 157 Hillside Ave., Waterbury,

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Carriage Manor LLC is a limited liability company.

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Carriage Manor LLC is required to be filed by the owners or members of the company.

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Carriage Manor LLC can be filled out by submitting the necessary forms and information to the appropriate state agency.

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The purpose of Carriage Manor LLC is to legally establish a limited liability company for business purposes.

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Information such as the company's name, address, owners or members, business purpose, and other relevant details must be reported on Carriage Manor LLC.

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