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  5. SHAFER SURGICAL, LLC

SHAFER SURGICAL, LLC

Company Details

Name: SHAFER SURGICAL, LLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 04 Feb 2008 (17 years ago)
Entity Number: 3626750
ZIP code: 11417
County: New York
Place of Formation: New York
Address: 535 5TH AVENUE, 33RD FLOOR, NEW YORK, NY, United States, 11417

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SHAFER SURGICAL LLC CASH BALANCE PLAN 2023 262056483 2024-10-15 SHAFER SURGICAL LLC 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 10 EAST 53RD STREET, 25TH FLOOR, NEW YORK, NY, 10022
SHAFER PLASTIC SURGERY 401(K) QRP 2023 262056483 2024-10-14 SHAFER SURGICAL LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-12-31
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 10 EAST 53RD STREET, 25TH FLOOR, NEW YORK, NY, 10022
SHAFER PLASTIC SURGERY 401(K) QRP 2022 262056483 2023-09-22 SHAFER SURGICAL LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-12-31
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 10 EAST 53RD STREET, 25TH FLOOR, NEW YORK, NY, 10022

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-09-22
Name of individual signing TARA EVANS, FOR TAG RESOURCES
SHAFER SURGICAL LLC CASH BALANCE PLAN 2022 262056483 2023-08-23 SHAFER SURGICAL LLC 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 10 EAST 53RD STREET, 25TH FLOOR, NEW YORK, NY, 10022
SHAFER PLASTIC SURGERY 401(K) QRP 2021 262056483 2023-09-21 SHAFER SURGICAL LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-12-31
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 35 FIFTH AVENUE 33RD FLOOR, NEW YORK, NY, 10017

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-09-21
Name of individual signing TARA EVANS, FOR TAG RESOURCES
SHAFER SURGICAL LLC CASH BALANCE PLAN 2021 262056483 2022-09-07 SHAFER SURGICAL LLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 10 EAST 53RD STREET, 25TH FLOOR, NEW YORK, NY, 10022
SHAFER PLASTIC SURGERY 401(K) QRP 2021 262056483 2022-09-23 SHAFER SURGICAL LLC 5
Three-digit plan number (PN) 001
Effective date of plan 2009-12-31
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 35 FIFTH AVENUE 33RD FLOOR, NEW YORK, NY, 10017

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2022-09-23
Name of individual signing TARA EVANS
SHAFER PLASTIC SURGERY 401(K) QRP 2020 262056483 2021-05-17 SHAFER SURGICAL LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-12-31
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 10 EAST 53RD STREET, 25TH FLOOR, NEW YORK, NY, 10022

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-05-17
Name of individual signing PHIL TISUE
SHAFER SURGICAL LLC CASH BALANCE PLAN 2020 262056483 2021-10-04 SHAFER SURGICAL LLC 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 10 EAST 53RD STREET, 25TH FLOOR, NEW YORK, NY, 10022
SHAFER SURGICAL LLC CASH BALANCE PLAN 2019 262056483 2020-10-15 SHAFER SURGICAL LLC 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 2128887770
Plan sponsor’s address 10 EAST 53RD STREET, 25TH FLOOR, NEW YORK, NY, 10022

DOS Process Agent

Name Role Address
SHAFER SURGICAL, LLC DOS Process Agent 535 5TH AVENUE, 33RD FLOOR, NEW YORK, NY, United States, 11417

History

Start date End date Type Value
2010-03-09 2020-02-07 Address 10 EAST 53RD STREET, 25TH FL, NEW YORK, NY, 10022, USA (Type of address: Service of Process)
2008-02-04 2010-03-09 Address 450 EAST 63RD STREET, #10G, NEW YORK, NY, 10021, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
200207060057 2020-02-07 BIENNIAL STATEMENT 2020-02-01
180209006010 2018-02-09 BIENNIAL STATEMENT 2018-02-01
140207006577 2014-02-07 BIENNIAL STATEMENT 2014-02-01
120315002426 2012-03-15 BIENNIAL STATEMENT 2012-02-01
100309002936 2010-03-09 BIENNIAL STATEMENT 2010-02-01
080703000874 2008-07-03 CERTIFICATE OF PUBLICATION 2008-07-03
080204000609 2008-02-04 ARTICLES OF ORGANIZATION 2008-02-04

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 27 Nov 2024

Sources: New York Secretary of State

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