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LEATHERSTOCKING HEALTHCARE, LLC

Company Details

Name: LEATHERSTOCKING HEALTHCARE, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Inactive
Date of registration: 27 Jan 2005 (20 years ago) (Companies founded in January 2005)
Date of dissolution: 14 Nov 2017
Entity Number: 3156399
ZIP code: 13350 (Companies in Herkimer, 13350)
County: Herkimer
Place of Formation: New York
Address: 321 N BELLINGER ST, HERKIMER, NY, United States, 13350

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COUNTRYSIDE CARE CENTER EMPLOYEE SAVINGS PLAN AND TRUST 2012 542170339 2013-10-01 LEATHERSTOCKING HEALTHCARE, LLC 162
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-15
Business code 623000
Sponsor’s telephone number 3152195548
Plan sponsor’s mailing address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Plan sponsor’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350

Number of participants as of the end of the plan year
Other retired or separated participants entitled to future benefits 49
Number of participants with account balances as of the end of the plan year 49

Signature of
Role Plan administrator
Date 2013-10-01
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-01
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
COUNTRYSIDE CARE CENTER EMPLOYEE SAVINGS PLAN AND TRUST 2012 542170339 2013-10-25 LEATHERSTOCKING HEALTHCARE, LLC 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-15
Business code 623000
Sponsor’s telephone number 3152195548
Plan sponsor’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350

Signature of
Role Plan administrator
Date 2013-10-25
Name of individual signing ERNEST ORTS
Role Employer/plan sponsor
Date 2013-10-25
Name of individual signing ERNEST ORTS
COUNTRYSIDE CARE CENTER EMPLOYEE SAVINGS PLAN AND TRUST 2011 542170339 2012-10-10 LEATHERSTOCKING HEALTHCARE, LLC 168
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-15
Business code 623000
Sponsor’s telephone number 3152195548
Plan sponsor’s mailing address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Plan sponsor’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350

Plan administrator’s name and address
Administrator’s EIN 542170339
Plan administrator’s name LEATHERSTOCKING HEALTHCARE, LLC
Plan administrator’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Administrator’s telephone number 3152195548

Number of participants as of the end of the plan year
Active participants 119
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 34
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 91
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-10-09
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-09
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
COUNTRYSIDE CARE CENTER EMPLOYEE SAVINGS PLAN AND TRUST 2011 542170339 2012-10-09 LEATHERSTOCKING HEALTHCARE, LLC 168
Three-digit plan number (PN) 001
Effective date of plan 2007-03-15
Business code 623000
Sponsor’s telephone number 3152195548
Plan sponsor’s mailing address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Plan sponsor’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350

Plan administrator’s name and address
Administrator’s EIN 542170339
Plan administrator’s name LEATHERSTOCKING HEALTHCARE, LLC
Plan administrator’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Administrator’s telephone number 3152195548

Number of participants as of the end of the plan year
Active participants 119
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 34
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 91
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-10-09
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-09
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
FLEXIBLE SPENDING ACCOUNT PLAN 2011 542170339 2012-06-12 LEATHERSTOCKING HEALTHCARE, LLC 129
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 623000
Sponsor’s telephone number 3158666406
Plan sponsor’s DBA name COUNTRYSIDE CARE CENTER
Plan sponsor’s mailing address 321 N. BELLINGER STREET, HERKIMER, NY, 13350
Plan sponsor’s address 321 N. BELLINGER STREET, HERKIMER, NY, 13350

Plan administrator’s name and address
Administrator’s EIN 542170339
Plan administrator’s name LEATHERSTOCKING HEALTHCARE, LLC
Plan administrator’s address 321 N. BELLINGER STREET, HERKIMER, NY, 13350
Administrator’s telephone number 3158666406

Number of participants as of the end of the plan year
Active participants 74

Signature of
Role Plan administrator
Date 2012-06-08
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
COUNTRYSIDE CARE CENTER EMPLOYEE SAVINGS PLAN AND TRUST 2010 542170339 2011-10-14 LEATHERSTOCKING HEALTHCARE, LLC 166
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-15
Business code 623000
Sponsor’s telephone number 3158686406
Plan sponsor’s mailing address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Plan sponsor’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350

Plan administrator’s name and address
Administrator’s EIN 542170339
Plan administrator’s name LEATHERSTOCKING HEALTHCARE, LLC
Plan administrator’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Administrator’s telephone number 3158686406

Number of participants as of the end of the plan year
Active participants 134
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 26
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 107
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-14
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
FLEXIBLE SPENDING ACCOUNT PLAN 2010 542170339 2011-10-05 LEATHERSTOCKING HEALTHCARE, LLC 149
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 623000
Sponsor’s telephone number 3158666406
Plan sponsor’s DBA name COUNTRYSIDE CARE CENTER
Plan sponsor’s mailing address 321 N. BELLINGER STREET, HERKIMER, NY, 13350
Plan sponsor’s address 321 N. BELLINGER STREET, HERKIMER, NY, 13350

Plan administrator’s name and address
Administrator’s EIN 542170339
Plan administrator’s name LEATHERSTOCKING HEALTHCARE, LLC
Plan administrator’s address 321 N. BELLINGER STREET, HERKIMER, NY, 13350
Administrator’s telephone number 3158666406

Number of participants as of the end of the plan year
Active participants 129

Signature of
Role Plan administrator
Date 2011-10-03
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
FLEXIBLE SPENDING ACCOUNT PLAN 2009 542170339 2010-11-12 LEATHERSTOCKING HEALTHCARE, LLC 192
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 623000
Sponsor’s telephone number 3158666406
Plan sponsor’s DBA name COUNTRYSIDE CARE CENTER
Plan sponsor’s mailing address 321 N. BELLINGER STREET, HERKIMER, NY, 13350
Plan sponsor’s address 321 N. BELLINGER STREET, HERKIMER, NY, 13350

Plan administrator’s name and address
Administrator’s EIN 542170339
Plan administrator’s name LEATHERSTOCKING HEALTHCARE, LLC
Plan administrator’s address 321 N. BELLINGER STREET, HERKIMER, NY, 13350
Administrator’s telephone number 3158666406

Number of participants as of the end of the plan year
Active participants 149

Signature of
Role Plan administrator
Date 2010-11-12
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
COUNTRYSIDE CARE CENTER EMPLOYEE SAVINGS PLAN AND TRUST 2009 542170339 2010-10-13 LEATHERSTOCKING HEALTHCARE, LLC 167
Three-digit plan number (PN) 001
Effective date of plan 2007-03-15
Business code 623000
Sponsor’s telephone number 3158686406
Plan sponsor’s mailing address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Plan sponsor’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350

Plan administrator’s name and address
Administrator’s EIN 542170339
Plan administrator’s name LEATHERSTOCKING HEALTHCARE, LLC
Plan administrator’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Administrator’s telephone number 3158686406

Number of participants as of the end of the plan year
Active participants 142
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 17
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 111
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-13
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
COUNTRYSIDE CARE CENTER EMPLOYEE SAVINGS PLAN AND TRUST 2009 542170339 2010-10-13 LEATHERSTOCKING HEALTHCARE, LLC 167
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-15
Business code 623000
Sponsor’s telephone number 3158686406
Plan sponsor’s mailing address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Plan sponsor’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350

Plan administrator’s name and address
Administrator’s EIN 542170339
Plan administrator’s name LEATHERSTOCKING HEALTHCARE, LLC
Plan administrator’s address 321 NORTH BELLINGER STREET, HERKIMER, NY, 13350
Administrator’s telephone number 3158686406

Number of participants as of the end of the plan year
Active participants 142
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 17
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 111
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-13
Name of individual signing ERNEST ORTS
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 321 N BELLINGER ST, HERKIMER, NY, United States, 13350

History

Start date End date Type Value
2005-01-27 2009-01-06 Address 439 SMALLS BUSH ROAD, HERKIMER, NY, 13350, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
171114000080 2017-11-14 ARTICLES OF DISSOLUTION 2017-11-14
110426003098 2011-04-26 BIENNIAL STATEMENT 2011-01-01
090106002173 2009-01-06 BIENNIAL STATEMENT 2009-01-01
070212000964 2007-02-12 CERTIFICATE OF PUBLICATION 2007-02-12
061220002054 2006-12-20 BIENNIAL STATEMENT 2007-01-01
061205000227 2006-12-05 CERTIFICATE OF AMENDMENT 2006-12-05
050127000632 2005-01-27 ARTICLES OF ORGANIZATION 2005-01-27

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Date of last update: 10 Nov 2024

Sources: New York Secretary of State

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