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  5. BROOKVILLE COUNTRY CLUB, INC.

BROOKVILLE COUNTRY CLUB, INC.

Company Details

Name: BROOKVILLE COUNTRY CLUB, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 18 May 1922 (103 years ago)
Entity Number: 17843
ZIP code: 11545
County: Nassau
Place of Formation: New York
Address: (NO STREET ADD. STATED), GLEN HEAD, NY, United States, 11545

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BROOKVILLE COUNTRY CLUB 401(K) PLAN 2014 110585380 2015-08-17 BROOKVILLE COUNTRY CLUB 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 713900
Sponsor’s telephone number 5166715440
Plan sponsor’s address 210 CHICKEN VALLEY ROAD, OLD BROOKVILLE, NY, 11545

Signature of
Role Plan administrator
Date 2015-08-17
Name of individual signing MICHAEL BORGIA
BROOKVILLE COUNTRY CLUB 401(K) PLAN 2013 110585380 2014-10-02 BROOKVILLE COUNTRY CLUB 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 713900
Sponsor’s telephone number 5166715440
Plan sponsor’s address 210 CHICKEN VALLEY ROAD, OLD BROOKVILLE, NY, 11545

Signature of
Role Plan administrator
Date 2014-10-02
Name of individual signing MICHAEL BORGIA
BROOKVILLE COUNTRY CLUB 401(K) PLAN 2012 110585380 2013-10-07 BROOKVILLE COUNTRY CLUB 79
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 713900
Sponsor’s telephone number 5166715440
Plan sponsor’s address 210 CHICKEN VALLEY ROAD, OLD BROOKVILLE, NY, 11545

Signature of
Role Plan administrator
Date 2013-10-07
Name of individual signing MICHAEL BORGIA
BROOKVILLE COUNTRY CLUB 401(K) PLAN 2011 110585380 2012-10-09 BROOKVILLE COUNTRY CLUB 89
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 713900
Sponsor’s telephone number 5166715440
Plan sponsor’s address 210 CHICKEN VALLEY ROAD, OLD BROOKVILLE, NY, 11545

Plan administrator’s name and address
Administrator’s EIN 110585380
Plan administrator’s name BROOKVILLE COUNTRY CLUB
Plan administrator’s address 210 CHICKEN VALLEY ROAD, OLD BROOKVILLE, NY, 11545
Administrator’s telephone number 5166715440

Signature of
Role Plan administrator
Date 2012-10-09
Name of individual signing MICHAEL BORGIA
BROOKVILLE COUNTRY CLUB 401(K) PLAN 2010 110585380 2011-10-04 BROOKVILLE COUNTRY CLUB 85
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 713900
Sponsor’s telephone number 5166715440
Plan sponsor’s address 210 CHICKEN VALLEY ROAD, OLD BROOKVILLE, NY, 11545

Plan administrator’s name and address
Administrator’s EIN 110585380
Plan administrator’s name BROOKVILLE COUNTRY CLUB
Plan administrator’s address 210 CHICKEN VALLEY ROAD, OLD BROOKVILLE, NY, 11545
Administrator’s telephone number 5166715440

Signature of
Role Plan administrator
Date 2011-10-04
Name of individual signing PAUL A. KELLER
BROOKVILLE COUNTRY CLUB 401(K) PLAN 2009 110585380 2010-09-01 BROOKVILLE COUNTRY CLUB 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 713900
Sponsor’s telephone number 5166715440
Plan sponsor’s address 210 CHICKEN VALLEY ROAD, OLD BROOKVILLE, NY, 11545

Plan administrator’s name and address
Administrator’s EIN 110585380
Plan administrator’s name BROOKVILLE COUNTRY CLUB
Plan administrator’s address 210 CHICKEN VALLEY ROAD, OLD BROOKVILLE, NY, 11545
Administrator’s telephone number 5166715440

Signature of
Role Plan administrator
Date 2010-09-01
Name of individual signing PAUL A. KELLER

DOS Process Agent

Name Role Address
BROOKVILLE COUNTRY CLUB, INC. DOS Process Agent (NO STREET ADD. STATED), GLEN HEAD, NY, United States, 11545

Licenses

Number Type Date Last renew date End date Address Description
0349-23-124662 Alcohol sale 2023-03-02 2023-03-02 2025-02-28 210 CHICKEN VALLEY ROAD, BROOKVILLE, New York, 11545 Club
0423-23-131409 Alcohol sale 2023-03-02 2023-03-02 2025-02-28 210 CHICKEN VALLEY ROAD, BROOKVILLE, New York, 11545 Additional Bar

Filings

Filing Number Date Filed Type Effective Date
B053799-2 1983-12-29 ASSUMED NAME CORP INITIAL FILING 1983-12-29
A102398-2 1973-09-20 CERTIFICATE OF AMENDMENT 1973-09-20
18EX236 1951-05-22 CERTIFICATE OF AMENDMENT 1951-05-22
206Q-85 1922-05-18 CERTIFICATE OF INCORPORATION 1922-05-18

Related by officers

No related officers

Related by address

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Date of last update: 17 Nov 2024

Sources: New York Secretary of State

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