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  5. ROMAN & FERCHAW A DENTAL PRACTICE, PLLC

ROMAN & FERCHAW A DENTAL PRACTICE, PLLC

Company Details

Name: ROMAN & FERCHAW A DENTAL PRACTICE, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 21 Apr 1998 (27 years ago)
Entity Number: 2251313
ZIP code: 14801
County: Steuben
Place of Formation: New York
Address: 138 FRONT ST, ADDISON, NY, United States, 14801

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE BENEFIT PLAN OF ROMAN & FERCHAW A DENTAL PRACTICE,PLLC 2016 161422738 2017-07-19 ROMAN & FERCHAW A DENTAL PRACTICE, PLLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6073593367
Plan sponsor’s address 138 FRONT ST, ADDISON, NY, 14801

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing MARK ROMAN
Role Employer/plan sponsor
Date 2017-07-19
Name of individual signing MARK ROMAN
EMPLOYEE BENEFIT PLAN OF ROMAN & FERCHAW A DENTAL PRACTICE,PLLC 2015 161422738 2016-07-12 ROMAN & FERCHAW A DENTAL PRACTICE, PLLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6073593367
Plan sponsor’s address 138 FRONT ST, ADDISON, NY, 14801

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing MARK ROMAN
Role Employer/plan sponsor
Date 2016-07-12
Name of individual signing MARK ROMAN
EMPLOYEE BENEFIT PLAN OF ROMAN & FERCHAW A DENTAL PRACTICE,PLLC 2014 161422738 2015-10-08 ROMAN & FERCHAW A DENTAL PRACTICE, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6073593367
Plan sponsor’s address 138 FRONT ST, ADDISON, NY, 14801

Signature of
Role Plan administrator
Date 2015-10-08
Name of individual signing MARK ROMAN
Role Employer/plan sponsor
Date 2015-10-08
Name of individual signing MARK ROMAN
ROMAN & FERCHAW A DENTAL PRACTICE, PLLC 401(K) PLAN 2013 161422738 2014-06-05 ROMAN & FERCHAW A DENTAL PRACTICE, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6073593367
Plan sponsor’s address 138 EAST FRONT STREET, ADDISON, NY, 14801

Signature of
Role Plan administrator
Date 2014-06-05
Name of individual signing MARK ROMAN
ROMAN & FERCHAW A DENTAL PRACTICE, PLLC 401(K) PLAN 2012 161422738 2013-08-13 ROMAN & FERCHAW A DENTAL PRACTICE, PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6073593367
Plan sponsor’s address 138 EAST FRONT STREET, ADDISON, NY, 14801

Signature of
Role Plan administrator
Date 2013-08-13
Name of individual signing MARK ROMAN
MICHAEL F FERCHAW DMD MARK A 401K PROFIT SHARING PLAN TRUST 2011 161422738 2012-06-14 ROMAN & FERCHAW A DENTAL PRACTICE, PLLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 6073593367
Plan sponsor’s address 138 EAST FRONT STREET, ADDISON, NY, 14801

Plan administrator’s name and address
Administrator’s EIN 161422738
Plan administrator’s name ROMAN & FERCHAW A DENTAL PRACTICE, PLLC
Plan administrator’s address 138 EAST FRONT STREET, ADDISON, NY, 14801
Administrator’s telephone number 6073593367

Signature of
Role Plan administrator
Date 2012-06-14
Name of individual signing MARK ROMAN

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 138 FRONT ST, ADDISON, NY, United States, 14801

History

Start date End date Type Value
2004-04-13 2006-04-03 Address 138 GRANT ST, ADDISON, NY, 14801, USA (Type of address: Service of Process)
1998-04-21 2004-04-13 Address 138 EAST FRONT STREET, ADDISON, NY, 14801, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
140710002075 2014-07-10 BIENNIAL STATEMENT 2014-04-01
120516002973 2012-05-16 BIENNIAL STATEMENT 2012-04-01
100421002387 2010-04-21 BIENNIAL STATEMENT 2010-04-01
080408002495 2008-04-08 BIENNIAL STATEMENT 2008-04-01
060403002027 2006-04-03 BIENNIAL STATEMENT 2006-04-01
040413002045 2004-04-13 BIENNIAL STATEMENT 2004-04-01
020403002116 2002-04-03 BIENNIAL STATEMENT 2002-04-01
000406002048 2000-04-06 BIENNIAL STATEMENT 2000-04-01
980828000433 1998-08-28 AFFIDAVIT OF PUBLICATION 1998-08-28
980828000432 1998-08-28 AFFIDAVIT OF PUBLICATION 1998-08-28

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Date of last update: 12 Nov 2024

Sources: New York Secretary of State

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