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DEROBERTS PLASTIC SURGERY, PLLC

Company Details

Name: DEROBERTS PLASTIC SURGERY, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 05 Aug 2010 (14 years ago) (Companies founded in August 2010)
Entity Number: 3981603
ZIP code: 13215 (Companies in New York, 13215)
County: New York
Place of Formation: New York
Address: 4900 BROAD ROAD, SUITE 2G, SYRACUSE, NY, United States, 13215

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' PROFIT SHARING PLAN & TRUST 2020 273201241 2021-09-29 DEROBERTS PLASTIC SURGERY, PLLC 11
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 3107 EAST GENESEE STREET, SYRACUSE, NY, 13224

Signature of
Role Plan administrator
Date 2021-09-29
Name of individual signing DEAN DEROBERTS
Role Employer/plan sponsor
Date 2021-09-29
Name of individual signing DEAN DEROBERTS
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' DEFINED BENEFIT PLAN AND TRUST 2020 273201241 2021-09-29 DEROBERTS PLASTIC SURGERY, PLLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 3107 EAST GENESEE STREET, SYRACUSE, NY, 13224

Signature of
Role Plan administrator
Date 2021-09-29
Name of individual signing DEAN DEROBERTS
Role Employer/plan sponsor
Date 2021-09-29
Name of individual signing DEAN DEROBERTS
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' DEFINED BENEFIT PLAN AND TRUST 2019 273201241 2020-09-29 DEROBERTS PLASTIC SURGERY, PLLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 3107 EAST GENESEE STREET, SYRACUSE, NY, 13224

Signature of
Role Plan administrator
Date 2020-09-29
Name of individual signing DEAN DEROBERTS
Role Employer/plan sponsor
Date 2020-09-29
Name of individual signing DEAN DEROBERTS
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' PROFIT SHARING PLAN & TRUST 2019 273201241 2020-09-29 DEROBERTS PLASTIC SURGERY, PLLC 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 3107 EAST GENESEE STREET, SYRACUSE, NY, 13224

Signature of
Role Plan administrator
Date 2020-09-29
Name of individual signing DEAN DEROBERTS
Role Employer/plan sponsor
Date 2020-09-29
Name of individual signing DEAN DEROBERTS
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' PROFIT SHARING PLAN & TRUST 2018 273201241 2019-09-24 DEROBERTS PLASTIC SURGERY, PLLC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 4900 BROAD RD COMMUNITY HOSPITAL, POB, SOUTH 2G, SYRACUSE, NY, 132155103

Signature of
Role Plan administrator
Date 2019-09-24
Name of individual signing DEAN DEROBERTS
Role Employer/plan sponsor
Date 2019-09-24
Name of individual signing DEAN DEROBERTS
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' DEFINED BENEFIT PLAN AND TRUST 2018 273201241 2019-09-24 DEROBERTS PLASTIC SURGERY, PLLC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 4900 BROAD RD COMMUNITY HOSPITAL, POB, SOUTH 2, SYRACUSE, NY, 132155103

Signature of
Role Plan administrator
Date 2019-09-24
Name of individual signing DEAN DEROBERTS
Role Employer/plan sponsor
Date 2019-09-24
Name of individual signing DEAN DEROBERTS
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' PROFIT SHARING PLAN & TRUST 2017 273201241 2018-08-27 DEROBERTS PLASTIC SURGERY, PLLC 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 4900 BROAD RD COMMUNITY HOSPITAL, POB, SOUTH 2, SYRACUSE, NY, 132155103

Signature of
Role Plan administrator
Date 2018-08-27
Name of individual signing DEAN DEROBERTS
Role Employer/plan sponsor
Date 2018-08-27
Name of individual signing DEAN DEROBERTS
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' DEFINED BENEFIT PLAN AND TRUST 2017 273201241 2018-08-27 DEROBERTS PLASTIC SURGERY, PLLC 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 4900 BROAD RD COMMUNITY HOSPITAL, POB, SOUTH 2, SYRACUSE, NY, 132155103

Signature of
Role Plan administrator
Date 2018-08-27
Name of individual signing DEAN DEROBERTS
Role Employer/plan sponsor
Date 2018-08-27
Name of individual signing DEAN DEROBERTS
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' DEFINED BENEFIT PLAN AND TRUST 2016 273201241 2017-09-25 DEROBERTS PLASTIC SURGERY, PLLC 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 4900 BROAD RD COMMUNITY HOSPITAL, POB, SOUTH 2, SYRACUSE, NY, 132155103

Signature of
Role Plan administrator
Date 2017-09-25
Name of individual signing KEVIN J. DONOVAN
Role Employer/plan sponsor
Date 2017-09-25
Name of individual signing KEVIN J. DONOVAN
DEROBERTS PLASTIC SURGERY, PLLC EMPLOYEES' PROFIT SHARING PLAN & TRUST 2016 273201241 2017-09-13 DEROBERTS PLASTIC SURGERY, PLLC 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3152995313
Plan sponsor’s address 4900 BROAD RD COMMUNITY HOSPITAL, POB, SOUTH 2, SYRACUSE, NY, 132155103

Signature of
Role Plan administrator
Date 2017-09-13
Name of individual signing KEVIN J. DONOVAN
Role Employer/plan sponsor
Date 2017-09-13
Name of individual signing KEVIN J. DONOVAN

DOS Process Agent

Name Role Address
DEROBERTS PLASTIC SURGERY, PLLC DOS Process Agent 4900 BROAD ROAD, SUITE 2G, SYRACUSE, NY, United States, 13215

History

Start date End date Type Value
2010-08-05 2014-08-14 Address 300 BRATTLE ROAD, SYRACUSE, NY, 13203, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
180806006276 2018-08-06 BIENNIAL STATEMENT 2018-08-01
140814006049 2014-08-14 BIENNIAL STATEMENT 2014-08-01
121115002132 2012-11-15 BIENNIAL STATEMENT 2012-08-01
101130000452 2010-11-30 CERTIFICATE OF PUBLICATION 2010-11-30
100805000733 2010-08-05 ARTICLES OF ORGANIZATION 2010-08-05

Related by officers

No related officers

Related by address

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Date of last update: 08 Nov 2024

Sources: New York Secretary of State

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