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NISSEQUOGUE GOLF CLUB, INC.

Company Details

Name: NISSEQUOGUE GOLF CLUB, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 24 Jun 1966 (59 years ago)
Entity Number: 199832
County: Suffolk
Place of Formation: New York

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2023 112134428 2024-06-28 NISSEQUOGUE GOLF CLUB 59
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Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address 21 GOLF CLUB ROAD, ST. JAMES, NY, 11780
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2022 112134428 2023-07-06 NISSEQUOGUE GOLF CLUB 52
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address 21 GOLF CLUB ROAD, ST. JAMES, NY, 11780

Signature of
Role Plan administrator
Date 2023-07-06
Name of individual signing TED LACKOWITZ
Role Employer/plan sponsor
Date 2023-07-06
Name of individual signing TED LACKOWITZ
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2021 112134428 2022-05-23 NISSEQUOGUE GOLF CLUB 51
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address 21 GOLF CLUB ROAD, ST. JAMES, NY, 11780

Signature of
Role Plan administrator
Date 2022-05-21
Name of individual signing TED LACKOWITZ
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2020 112134428 2021-09-22 NISSEQUOGUE GOLF CLUB 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address 21 GOLF CLUB ROAD, ST. JAMES, NY, 11780

Signature of
Role Plan administrator
Date 2021-09-22
Name of individual signing TED LACKOWITZ
Role Employer/plan sponsor
Date 2021-09-22
Name of individual signing TED LACKOWITZ
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2015 112134428 2016-09-08 NISSEQUOGUE GOLF CLUB 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address RFD 1 MORICHES ROAD, ST. JAMES, NY, 11780

Signature of
Role Plan administrator
Date 2016-09-08
Name of individual signing DONALD MUSGNUG
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2014 112134428 2015-10-05 NISSEQUOGUE GOLF CLUB 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address RFD 1 MORICHES ROAD, ST. JAMES, NY, 11780

Signature of
Role Plan administrator
Date 2015-10-05
Name of individual signing DONALD MUSGNUG
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2013 112134428 2014-07-10 NISSEQUOGUE GOLF CLUB 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address RFD 1 MORICHES ROAD, ST. JAMES, NY, 11780

Signature of
Role Plan administrator
Date 2014-07-09
Name of individual signing DONALD MUSGNUG
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2012 112134428 2013-07-29 NISSEQUOGUE GOLF CLUB 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address RFD 1 MORICHES ROAD, ST. JAMES, NY, 11780

Signature of
Role Plan administrator
Date 2013-07-29
Name of individual signing DONALD MUSGNUG
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2011 112134428 2012-06-20 NISSEQUOGUE GOLF CLUB 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address RFD 1 MORICHES ROAD, ST. JAMES, NY, 11780

Plan administrator’s name and address
Administrator’s EIN 112134428
Plan administrator’s name NISSEQUOGUE GOLF CLUB
Plan administrator’s address RFD 1 MORICHES ROAD, ST. JAMES, NY, 11780
Administrator’s telephone number 6315847733

Signature of
Role Plan administrator
Date 2012-06-20
Name of individual signing TED LACKOWITZ
NISSEQUOGUE GOLF CLUB 401(K) PROFIT SHARING PLAN 2010 112134428 2011-03-07 NISSEQUOGUE GOLF CLUB 39
Three-digit plan number (PN) 001
Effective date of plan 1997-01-01
Business code 713900
Sponsor’s telephone number 6315847733
Plan sponsor’s address RFD 1 MORICHES ROAD, ST. JAMES, NY, 11780

Plan administrator’s name and address
Administrator’s EIN 112134428
Plan administrator’s name NISSEQUOGUE GOLF CLUB
Plan administrator’s address RFD 1 MORICHES ROAD, ST. JAMES, NY, 11780
Administrator’s telephone number 6315847733

Signature of
Role Employer/plan sponsor
Date 2011-03-07
Name of individual signing TED LACKOWITZ

Agent

Name Role Address
NISSEQUOGUE GOLF CLUB, INC. Agent MORICHES RD., NISSEQUOGUE, ST JAMES, NY

Licenses

Number Type Date Last renew date End date Address Description
0349-23-126857 Alcohol sale 2023-02-22 2023-02-22 2025-02-28 21 GOLF CLUB ROAD, SAINT JAMES, New York, 11780 Club
0423-23-132670 Alcohol sale 2023-02-22 2023-02-22 2025-02-28 21 GOLF CLUB ROAD, SAINT JAMES, New York, 11780 Additional Bar

Filings

Filing Number Date Filed Type Effective Date
C206071-2 1993-12-30 ASSUMED NAME CORP INITIAL FILING 1993-12-30
A181530-5 1974-09-13 CERTIFICATE OF AMENDMENT 1974-09-13
A95419-3 1973-08-28 CERTIFICATE OF AMENDMENT 1973-08-28
585312-4 1966-11-02 CERTIFICATE OF AMENDMENT 1966-11-02
565820-5 1966-06-24 CERTIFICATE OF INCORPORATION 1966-06-24

Related by officers

No related officers

Related by address

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Date of last update: 08 Jan 2025

Sources: New York Secretary of State

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