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  5. JACK E. KEISER, JR., M.D., P.C.

JACK E. KEISER, JR., M.D., P.C.

Company Details

Name: JACK E. KEISER, JR., M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 14 Oct 1999 (25 years ago)
Date of dissolution: 11 Mar 2014
Entity Number: 2428873
ZIP code: 13021
County: Cayuga
Place of Formation: New York
Address: 50 BROOKHOLLOW DRIVE, AUBURN, NY, United States, 13021

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
JACK E. KEISER, JR., M.D., P.C. 401(K) PLAN 2014 161572355 2015-10-09 JACK E. KEISER, JR., M.D.P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3152532785
Plan sponsor’s address 100 GENESEE STREET, AUBURN, NY, 13021

Signature of
Role Plan administrator
Date 2015-10-09
Name of individual signing JACK E. KEISER, JR., MD
JACK E. KEISER, JR., M.D., P.C. 401(K) PLAN 2013 161572355 2014-07-03 JACK E. KEISER, JR., M.D.P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3152532785
Plan sponsor’s address 100 GENESEE STREET, AUBURN, NY, 13021

Signature of
Role Plan administrator
Date 2014-07-03
Name of individual signing JACK E. KEISER, JR., MD
JACK E. KEISER, JR., M.D., P.C. 401(K) PLAN 2012 161572355 2013-09-23 JACK E. KEISER, JR., M.D.P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3152532785
Plan sponsor’s address 100 GENESEE STREET, AUBURN, NY, 13021

Signature of
Role Plan administrator
Date 2013-09-23
Name of individual signing JACK E. KEISER, JR., MD
JACK E. KEISER, JR., M.D., P.C. 401(K) PLAN 2011 161572355 2012-07-04 JACK E. KEISER, JR., M.D.P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3152532785
Plan sponsor’s address 100 GENESEE STREET, AUBURN, NY, 13021

Plan administrator’s name and address
Administrator’s EIN 161572355
Plan administrator’s name JACK E. KEISER, JR., M.D.P.C.
Plan administrator’s address 100 GENESEE STREET, AUBURN, NY, 13021
Administrator’s telephone number 3152532785

Signature of
Role Plan administrator
Date 2012-07-04
Name of individual signing JACK E KEISER JR
Role Employer/plan sponsor
Date 2012-07-04
Name of individual signing JACK E KEISER JR
JACK E. KEISER, JR., M.D., P.C. 401(K) PLAN 2010 161572355 2011-06-30 JACK E, KEISER, JR, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3152532785
Plan sponsor’s address 100 GENESEE STREET, AUBURN, NY, 13021

Plan administrator’s name and address
Administrator’s EIN 161572355
Plan administrator’s name JACK E, KEISER, JR, M.D., P.C.
Plan administrator’s address 100 GENESEE STREET, AUBURN, NY, 13021
Administrator’s telephone number 3152532785

Signature of
Role Plan administrator
Date 2011-06-30
Name of individual signing JACK KEISER, MD
JACK E. KEISER, JR., M.D., P.C. 401(K) PLAN 2009 161572355 2010-10-06 JACK E, KEISER, JR, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3152532785
Plan sponsor’s address 100 GENESEE STREET, AUBURN, NY, 13021

Plan administrator’s name and address
Administrator’s EIN 161572355
Plan administrator’s name JACK E, KEISER, JR, M.D., P.C.
Plan administrator’s address 100 GENESEE STREET, AUBURN, NY, 13021
Administrator’s telephone number 3152532785

Signature of
Role Plan administrator
Date 2010-10-06
Name of individual signing JACK KEISER, MD

DOS Process Agent

Name Role Address
JACK E. KEISER, JR., M.D., P.C. DOS Process Agent 50 BROOKHOLLOW DRIVE, AUBURN, NY, United States, 13021

Chief Executive Officer

Name Role Address
JACK E KEISER JR Chief Executive Officer 50 BROOKHOLLOW DRIVE, AUBURN, NY, United States, 13021

History

Start date End date Type Value
2005-11-25 2013-10-21 Address 100 GENESEE STREET, AUBURN, NY, 13021, USA (Type of address: Principal Executive Office)
2005-11-25 2013-10-21 Address 100 GENESEE STREET, SUITE B, AUBURN, NY, 13021, USA (Type of address: Chief Executive Officer)
2005-11-25 2013-10-21 Address 100 GENESEE STREET, AUBURN, NY, 13021, USA (Type of address: Service of Process)
2003-10-15 2005-11-25 Address 100 GENESEE ST, AUBURN, NY, 13021, USA (Type of address: Chief Executive Officer)
2003-10-15 2005-11-25 Address 100 GENESEE ST, AUBURN, NY, 13021, USA (Type of address: Service of Process)
2003-10-15 2005-11-25 Address 100 GENESEE ST, AUBURN, NY, 13021, USA (Type of address: Principal Executive Office)
1999-10-14 2003-10-15 Address GENESEE STREET MALL, AUBURN, NY, 13021, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
140311000649 2014-03-11 CERTIFICATE OF DISSOLUTION 2014-03-11
131021006621 2013-10-21 BIENNIAL STATEMENT 2013-10-01
111020002487 2011-10-20 BIENNIAL STATEMENT 2011-10-01
091009002091 2009-10-09 BIENNIAL STATEMENT 2009-10-01
071030002358 2007-10-30 BIENNIAL STATEMENT 2007-10-01
051125002298 2005-11-25 BIENNIAL STATEMENT 2005-10-01
031015002314 2003-10-15 BIENNIAL STATEMENT 2003-10-01
991014000618 1999-10-14 CERTIFICATE OF INCORPORATION 1999-10-14

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 12 Nov 2024

Sources: New York Secretary of State

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