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 |
|
|