NISSEQUOGUE GOLF CLUB, INC.

File	View Page
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

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

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

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

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

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

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

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

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

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

In Care of Name	-
Group Exemption Number	0000
Subsection	Pleasure, Recreational, or Social Club
Affiliation	Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification	Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility	Contributions are not deductible.
Foundation	All organizations except 501(c)(3)
Tax Period	2023-12
Asset	10,000,000 to 49,999,999
Income	5,000,000 to 9,999,999
Filing Requirement	990 (all other) or 990EZ return
PF Filing Requirement	No 990-PF return
Accounting Period	Dec
Asset Amount	12364760
Income Amount	7704883
Form 990 Revenue Amount	7115604
National Taxonomy of Exempt Entities	M99 Public Safety, Disaster Preparedness & Relief N.E.C Recreation & Sports: Golf
Sort Name	-

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name	NISSEQUOGUE GOLF CLUB INC
EIN	11-2134428
Tax Period	202212
Filing Type	E
Return Type	990O
File	View File
Organization Name	NISSEQUOGUE GOLF CLUB INC
EIN	11-2134428
Tax Period	202112
Filing Type	E
Return Type	990O
File	View File
Organization Name	NISSEQUOGUE GOLF CLUB INC
EIN	11-2134428
Tax Period	202012
Filing Type	E
Return Type	990O
File	View File
Organization Name	NISSEQUOGUE GOLF CLUB INC
EIN	11-2134428
Tax Period	201912
Filing Type	P
Return Type	990O
File	View File
Organization Name	NISSEQUOGUE GOLF CLUB INC
EIN	11-2134428
Tax Period	201812
Filing Type	P
Return Type	990O
File	View File
Organization Name	NISSEQUOGUE GOLF CLUB INC
EIN	11-2134428
Tax Period	201612
Filing Type	P
Return Type	990O
File	View File