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  5. ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC.

ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC.

Company Details

Name: ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 21 Jun 1988 (37 years ago)
Entity Number: 1271572
ZIP code: 13367
County: Lewis
Place of Formation: New York
Address: RETIREMENT COMMUNITY INC, P.O. BOX 167, LOWVILLE, NY, United States, 13367

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TAX DEFERRED ANNUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2016 161333180 2017-07-24 ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 133674144

Signature of
Role Plan administrator
Date 2017-07-21
Name of individual signing CHRISTINA INGERSOLL
Role Employer/plan sponsor
Date 2017-07-21
Name of individual signing CHRISTINA INGERSOLL
TAX DEFERRED ANNUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2015 161333180 2016-07-29 ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 133674144

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing CHRISTINA INGERSOLL
Role Employer/plan sponsor
Date 2016-07-29
Name of individual signing CHRISTINA INGERSOLL
TAX DEFERRED AMMUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY INC 2013 161333180 2014-06-25 ADIRONDACK MENNONITE RETIREMENT COMMUNITY INC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIRCLE, LOWVILLE, NY, 13367

Signature of
Role Plan administrator
Date 2014-06-25
Name of individual signing CHRISTINA INGERSOLL
Role Employer/plan sponsor
Date 2014-06-25
Name of individual signing CHRISTINA INGERSOLL
TAX DEFERRED AMMUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY INC 2012 161333180 2014-06-25 ADIRONDACK MENNONITE RETIREMENT COMMUNITY INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIRCLE, LOWVILLE, NY, 13367

Signature of
Role Plan administrator
Date 2014-06-25
Name of individual signing CHRISTINA INGERSOLL
Role Employer/plan sponsor
Date 2014-06-25
Name of individual signing CHRISTINA INGERSOLL
TAX DEFERRED ANNUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2009 161333180 2010-10-14 ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367

Plan administrator’s name and address
Administrator’s EIN 161333180
Plan administrator’s name ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC.
Plan administrator’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367
Administrator’s telephone number 3153764333

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing DIANNE WARD
Role Employer/plan sponsor
Date 2010-10-14
Name of individual signing DIANNE WARD
TAX DEFERRED ANNUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2009 161333180 2010-10-14 ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367

Plan administrator’s name and address
Administrator’s EIN 161333180
Plan administrator’s name ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC.
Plan administrator’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367
Administrator’s telephone number 3153764333

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing DIANNE WARD
Role Employer/plan sponsor
Date 2010-10-14
Name of individual signing DIANNE WARD
TAX DEFERRED ANNUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2009 161333180 2010-10-14 ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367

Plan administrator’s name and address
Administrator’s EIN 161333180
Plan administrator’s name ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC.
Plan administrator’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367
Administrator’s telephone number 3153764333

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing DIANNE WARD
Role Employer/plan sponsor
Date 2010-10-14
Name of individual signing DIANNE WARD
TAX DEFERRED ANNUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2009 161333180 2010-10-15 ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367

Plan administrator’s name and address
Administrator’s EIN 161333180
Plan administrator’s name ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC.
Plan administrator’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367
Administrator’s telephone number 3153764333

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing DIANNE WARD
Role Employer/plan sponsor
Date 2010-10-15
Name of individual signing DIANNE WARD
TAX DEFERRED ANNUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2009 161333180 2010-10-14 ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367

Plan administrator’s name and address
Administrator’s EIN 161333180
Plan administrator’s name ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC.
Plan administrator’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367
Administrator’s telephone number 3153764333

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing DIANNE WARD
Role Employer/plan sponsor
Date 2010-10-14
Name of individual signing DIANNE WARD
TAX DEFERRED ANNUITY PLAN OF ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 2009 161333180 2010-10-14 ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 1999-12-01
Business code 623000
Sponsor’s telephone number 3153764333
Plan sponsor’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367

Plan administrator’s name and address
Administrator’s EIN 161333180
Plan administrator’s name ADIRONDACK MENNONITE RETIREMENT COMMUNITY, INC.
Plan administrator’s address 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367
Administrator’s telephone number 3153764333

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing DIANNE WARD

DOS Process Agent

Name Role Address
ADIRONDACK MENNONITE DOS Process Agent RETIREMENT COMMUNITY INC, P.O. BOX 167, LOWVILLE, NY, United States, 13367

Licenses

Number Type Date End date Address
21AD1104649 Appearance Enhancement Business License 2000-01-19 2028-02-22 5701 BROOKSIDE CIR, LOWVILLE, NY, 13367

Filings

Filing Number Date Filed Type Effective Date
B654664-9 1988-06-21 CERTIFICATE OF INCORPORATION 1988-06-21

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 19 Dec 2024

Sources: New York Secretary of State

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