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PERRY FUNERAL HOME, INC.

Company Details

Name: PERRY FUNERAL HOME, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 11 Mar 1965 (60 years ago) (Companies founded in March 1965)
Entity Number: 185290
ZIP code: 11563 (Companies in Nassau, 11563)
County: Nassau
Place of Formation: New York
Address: 118 UNION AVENUE, LYNBROOK, NY, United States, 11563
Principal Address: 118 UNION AVE, LYNBROOK, NY, United States, 11563

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PERRY FUNERAL HOME 401(K) P/S PLAN 2023 112067621 2024-06-26 PERRY FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVE, LYNBROOK, NY, 11563

Signature of

Role Plan administrator
Date 2024-05-30
Name of individual signing KENNETH LYSAK
Role Employer/plan sponsor
Date 2024-05-30
Name of individual signing KENNETH LYSAK
PERRY FUNERAL HOME 401(K) P/S PLAN 2022 112067621 2023-04-14 PERRY FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112067621
Plan administrator’s name PERRY FUNERAL HOME, INC.
Plan administrator’s address 118 UNION AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165931111

Signature of

Role Plan administrator
Date 2023-04-14
Name of individual signing KENNETH LYSAK
PERRY FUNERAL HOME 401(K) P/S PLAN 2021 112067621 2022-06-14 PERRY FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112067621
Plan administrator’s name PERRY FUNERAL HOME, INC.
Plan administrator’s address 118 UNION AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165931111

Signature of

Role Plan administrator
Date 2022-06-14
Name of individual signing KENNETH LYSAK
PERRY FUNERAL HOME 401(K) P/S PLAN 2020 112067621 2021-05-17 PERRY FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112067621
Plan administrator’s name PERRY FUNERAL HOME, INC.
Plan administrator’s address 118 UNION AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165931111

Signature of

Role Plan administrator
Date 2021-05-17
Name of individual signing KENNETH LYSAK
PERRY FUNERAL HOME 401(K) P/S PLAN 2019 112067621 2020-05-06 PERRY FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112067621
Plan administrator’s name PERRY FUNERAL HOME, INC.
Plan administrator’s address 118 UNION AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165931111

Signature of

Role Plan administrator
Date 2020-05-06
Name of individual signing KENNETH LYSAK
PERRY FUNERAL HOME 401(K) P/S PLAN 2018 112067621 2019-05-31 PERRY FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112067621
Plan administrator’s name PERRY FUNERAL HOME, INC.
Plan administrator’s address 118 UNION AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165931111

Signature of

Role Plan administrator
Date 2019-05-31
Name of individual signing KENNETH LYSAK
PERRY FUNERAL HOME 401(K) P/S PLAN 2017 112067621 2018-03-15 PERRY FUNERAL HOME, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112067621
Plan administrator’s name PERRY FUNERAL HOME, INC.
Plan administrator’s address 118 UNION AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165931111

Signature of

Role Plan administrator
Date 2018-03-15
Name of individual signing KENNETH LYSAK
PERRY FUNERAL HOME 401(K) P/S PLAN 2016 112067621 2017-05-05 PERRY FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112067621
Plan administrator’s name PERRY FUNERAL HOME, INC.
Plan administrator’s address 118 UNION AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165931111

Signature of

Role Plan administrator
Date 2017-05-05
Name of individual signing KENNETH LYSAK
PERRY FUNERAL HOME 401(K) P/S PLAN 2015 112067621 2016-03-16 PERRY FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112067621
Plan administrator’s name PERRY FUNERAL HOME, INC.
Plan administrator’s address 118 UNION AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165931111

Signature of

Role Plan administrator
Date 2016-03-16
Name of individual signing KENNETH LYSAK
PERRY FUNERAL HOME 401(K) P/S PLAN 2014 112067621 2015-07-07 PERRY FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 812210
Sponsor’s telephone number 5165931111
Plan sponsor’s address 118 UNION AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112067621
Plan administrator’s name PERRY FUNERAL HOME, INC.
Plan administrator’s address 118 UNION AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165931111

Signature of

Role Plan administrator
Date 2015-07-07
Name of individual signing KENNETH LYSAK

Chief Executive Officer

Name Role Address
KENNETH LYSAK JR Chief Executive Officer 118 UNION AVE, LYNBROOK, NY, United States, 11563

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 118 UNION AVENUE, LYNBROOK, NY, United States, 11563

History

Start date End date Type Value
1993-04-19 2003-03-14 Address 118 UNION AVENUE, LYNBROOK, NY, 11563, 0791, USA (Type of address: Chief Executive Officer)
1993-04-19 2003-03-14 Address 118 UNION AVENUE, LYNBROOK, NY, 11563, 0791, USA (Type of address: Principal Executive Office)
1965-03-11 1994-03-29 Address 118 UNION AVE., LYNBROOK, NY, 11563, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
130402002374 2013-04-02 BIENNIAL STATEMENT 2013-03-01
20120917046 2012-09-17 ASSUMED NAME CORP DISCONTINUANCE 2012-09-17
20120508023 2012-05-08 ASSUMED NAME CORP INITIAL FILING 2012-05-08
110413002337 2011-04-13 BIENNIAL STATEMENT 2011-03-01
090318002400 2009-03-18 BIENNIAL STATEMENT 2009-03-01
070316002801 2007-03-16 BIENNIAL STATEMENT 2007-03-01
050413002354 2005-04-13 BIENNIAL STATEMENT 2005-03-01
030314002769 2003-03-14 BIENNIAL STATEMENT 2003-03-01
010314002493 2001-03-14 BIENNIAL STATEMENT 2001-03-01
990316002506 1999-03-16 BIENNIAL STATEMENT 1999-03-01

Date of last update: 17 Nov 2024

Sources: New York Secretary of State