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HOSPICE OF ST. LAWRENCE VALLEY, INC.

Company Details

Name: HOSPICE OF ST. LAWRENCE VALLEY, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 27 Mar 1986 (39 years ago) (Companies founded in March 1986)
Entity Number: 1069025
ZIP code: 13676 (Companies in St. Lawrence, 13676)
County: St. Lawrence
Place of Formation: New York
Address: INC., P.O. BOX 469, POTSDAM, NY, United States, 13676

Contact Details

Phone +1 315-265-3105

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF HOSPICE OF ST. LAWRENCE VALLEY, INC. 2023 222627929 2024-07-03 HOSPICE OF ST. LAWRENCE VALLEY, INC. 52
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address PO BOX 510, POTSDAM, NY, 13676

Signature of

Role Plan administrator
Date 2024-07-03
Name of individual signing STACEY A. TARBOX
403(B) THRIFT PLAN OF HOSPICE OF ST. LAWRENCE VALLEY, INC. 2022 222627929 2023-07-11 HOSPICE OF ST. LAWRENCE VALLEY, INC. 52
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address 6805 US HIGHWAY 11, PO BOX 510, POTSDAM, NY, 13676

Signature of

Role Plan administrator
Date 2023-07-11
Name of individual signing RUTH FISHBECK
403(B) THRIFT PLAN OF HOSPICE OF ST. LAWRENCE VALLEY, INC. 2021 222627929 2022-07-19 HOSPICE OF ST. LAWRENCE VALLEY, INC. 70
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address 6805 US HIGHWAY 11, POTSDAM, NY, 13676

Signature of

Role Plan administrator
Date 2022-07-19
Name of individual signing RUTH FISHBECK
403(B) THRIFT PLAN OF HOSPICE OF ST. LAWRENCE VALLEY, INC. 2020 222627929 2021-07-02 HOSPICE OF ST. LAWRENCE VALLEY, INC. 71
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address 6805 US HIGHWAY 11, POTSDAM, NY, 13676

Signature of

Role Plan administrator
Date 2021-07-02
Name of individual signing RUTH FISHBECK
403(B) THRIFT PLAN OF HOSPICE OF ST. LAWRENCE VALLEY, INC. 2019 222627929 2020-07-28 HOSPICE OF ST. LAWRENCE VALLEY, INC. 67
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address 6805 US HIGHWAY 11, POTSDAM, NY, 13676

Signature of

Role Plan administrator
Date 2020-07-28
Name of individual signing ELIZABETH DEMO
403(B) THRIFT PLAN OF HOSPICE OF ST. LAWRENCE VALLEY, INC. 2018 222627929 2019-07-25 HOSPICE OF ST. LAWRENCE VALLEY, INC. 69
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address 6805 US HIGHWAY 11, POTSDAM, NY, 136763131

Signature of

Role Plan administrator
Date 2019-07-25
Name of individual signing ELIZABETH DEMO
403(B) THRIFT PLAN OF HOSPICE OF ST LAWRENCE VALLEY INC 2017 222627929 2018-07-16 HOSPICE OF ST LAWRENCE VALLEY INC 69
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address 6805 US HIGHWAY 11, POTSDAM, NY, 136763131

Signature of

Role Plan administrator
Date 2018-07-16
Name of individual signing ELIZABETH M. DEMO
Role Employer/plan sponsor
Date 2018-07-16
Name of individual signing ELIZABETH M. DEMO
403(B) THRIFT PLAN OF HOSPICE OF ST. LAWRENCE VALLEY, INC. 2016 222627929 2017-06-29 HOSPICE OF ST. LAWRENCE VALLEY, INC . 65
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address 6805 US HIGHWAY 11, POTSDAM, NY, 13676

Signature of

Role Plan administrator
Date 2017-06-29
Name of individual signing ELIZABETH M. DEMO
Role Employer/plan sponsor
Date 2017-06-29
Name of individual signing ELIZABETH M. DEMO
403(B) THRIFT PLAN OF HOSPICE OF ST. LAWRENCE VALLEY, INC. 2015 222627929 2016-05-19 HOSPICE OF ST. LAWRENCE VALLEY, INC . 64
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address 6805 US HIGHWAY 11, POTSDAM, NY, 13676

Signature of

Role Plan administrator
Date 2016-05-19
Name of individual signing STEPHANIE T. WALLACE
Role Employer/plan sponsor
Date 2016-05-19
Name of individual signing STEPHANIE T. WALLACE
403(B) THRIFT PLAN OF HOSPICE OF ST. LAWRENCE VALLEY, INC. 2014 222627929 2015-06-18 HOSPICE OF ST. LAWRENCE VALLEY, INC . 66
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2000-01-01
Business code 622000
Sponsor’s telephone number 3152653105
Plan sponsor’s address 6805 US HIGHWAY 11, POTSDAM, NY, 13676

Signature of

Role Plan administrator
Date 2015-06-18
Name of individual signing MACKENZIE F. SHOEN
Role Employer/plan sponsor
Date 2015-06-18
Name of individual signing MACKENZIE F. SHOEN

DOS Process Agent

Name Role Address
HOSPICE OF POTSDAM-CANTON, DOS Process Agent INC., P.O. BOX 469, POTSDAM, NY, United States, 13676

History

Start date End date Type Value
1986-03-27 1988-12-28 Address 24 LEROY ST, POTSDAM, NY, 13676, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
B722764-9 1988-12-28 CERTIFICATE OF AMENDMENT 1988-12-28
B339168-12 1986-03-27 CERTIFICATE OF INCORPORATION 1986-03-27

Date of last update: 15 Nov 2024

Sources: New York Secretary of State