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BLACK CREEK ANIMAL CLINIC, LLC

Company Details

Name: BLACK CREEK ANIMAL CLINIC, LLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 11 Mar 2013 (12 years ago)
Entity Number: 4371992
ZIP code: 13069
County: Oswego
Place of Formation: New York
Address: 2899 COUNTY ROUTE 57, FULTON, NY, United States, 13069

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLACK CREEK ANIMAL CLINIC LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 462356192 2021-05-18 BLACK CREEK ANIMAL CLINIC LLC 9
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Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541940
Sponsor’s telephone number 3154848430
Plan sponsor’s address 2899 COUNTY ROUTE 57, FULTON, NY, 13069

Plan administrator’s name and address

Administrator’s EIN 471637791
Plan administrator’s name ERISA FIDUCIARY SERVICES
Plan administrator’s address 1373 VETERAN'S MEMORIAL HWY, SUITE 10, HAUPPAUGE, NY, 11788
Administrator’s telephone number 6312490500

Signature of

Role Plan administrator
Date 2021-05-18
Name of individual signing ERISA FIDUCIARY SERVICES
BLACK CREEK ANIMAL CLINIC LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 462356192 2020-04-09 BLACK CREEK ANIMAL CLINIC LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541940
Sponsor’s telephone number 3154848430
Plan sponsor’s address 2899 COUNTY ROUTE 57, FULTON, NY, 13069

Signature of

Role Plan administrator
Date 2020-04-09
Name of individual signing ERISA FIDUCIARY SERVICES
BLACK CREEK ANIMAL CLINIC LLC 401 K PROFIT SHARING PLAN TRUST 2018 462356192 2019-04-23 BLACK CREEK ANIMAL CLINIC LLC 8
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541940
Sponsor’s telephone number 3154848430
Plan sponsor’s address 2899 COUNTY ROUTE 57, FULTON, NY, 13069

Signature of

Role Plan administrator
Date 2019-04-23
Name of individual signing ERISA FIDUCIARY SERVICES, INC
BLACK CREEK ANIMAL CLINIC LLC 401 K PROFIT SHARING PLAN TRUST 2018 462356192 2019-04-23 BLACK CREEK ANIMAL CLINIC LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541940
Sponsor’s telephone number 3154848430
Plan sponsor’s address 2899 COUNTY ROUTE 57, FULTON, NY, 13069

Signature of

Role Plan administrator
Date 2019-04-23
Name of individual signing ERISA FIDUCIARY SERVICES, INC

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 2899 COUNTY ROUTE 57, FULTON, NY, United States, 13069

Filings

Filing Number Date Filed Type Effective Date
130617000031 2013-06-17 CERTIFICATE OF PUBLICATION 2013-06-17
130311000803 2013-03-11 ARTICLES OF ORGANIZATION 2013-03-11

Date of last update: 25 Nov 2024

Sources: New York Secretary of State