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  5. IVES HILL RETIREMENT COMMUNITY, INC.

IVES HILL RETIREMENT COMMUNITY, INC.

Company Details

Name: IVES HILL RETIREMENT COMMUNITY, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 12 Jun 1997 (28 years ago)
Entity Number: 2152551
ZIP code: 13601
County: Jefferson
Place of Formation: New York
Address: P.O. BOX 632, JEWELL DRIVE, WATERTOWN, NY, United States, 13601

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
IVES HILL RETIREMENT COMMUNITY 401(K) PROFIT SHARING PLAN & TRUST 2020 161529379 2021-03-24 IVES HILL RETIREMENT COMMUNITY 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 812990
Sponsor’s telephone number 3317799590
Plan sponsor’s address 1200 JEWELL DR, WATERTOWN, NY, 136014247

Signature of
Role Plan administrator
Date 2021-03-24
Name of individual signing ANNA PATTERSON
IVES HILL RETIREMENT COMMUNITY 2020 161529379 2021-03-24 IVES HILL RETIREMENT COMMUNITY 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 812990
Sponsor’s telephone number 3157799590
Plan sponsor’s address 1200 JEWELL DR, WATERTOWN, NY, 136014247

Signature of
Role Plan administrator
Date 2021-03-24
Name of individual signing ANNA PATTERSON
IVES HILL RETIREMENT COMMUNITY 2016 161529379 2017-10-16 IVES HILL RETIREMENT COMMUNITY 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 812990
Sponsor’s telephone number 3157799590
Plan sponsor’s address 1200 JEWELL DR, WATERTOWN, NY, 136014247

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing STACEY BRISTOW
Role Employer/plan sponsor
Date 2017-10-16
Name of individual signing STACEY BRISTOW
IVES HILL RETIREMENT COMMUNITY 401 K PROFIT SHARING PLAN TRUST 2015 161529379 2016-06-23 IVES HILL RETIREMENT COMMUNITY 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 812990
Sponsor’s telephone number 3157799590
Plan sponsor’s address 1200 JEWELL DRIVE, WATERTOWN, NY, 13601

Signature of
Role Plan administrator
Date 2016-06-23
Name of individual signing NIKKI REITEMA
IVES HILL RETIREMENT COMMUNITY 401 K PROFIT SHARING PLAN TRUST 2014 161529379 2015-05-07 IVES HILL RETIREMENT COMMUNITY 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 812990
Sponsor’s telephone number 3157799590
Plan sponsor’s address 1200 JEWELL DRIVE, WATERTOWN, NY, 13601

Signature of
Role Plan administrator
Date 2015-05-07
Name of individual signing NIKKI REITEMA
IVES HILL RETIREMENT COMMUNITY 401 K PROFIT SHARING PLAN TRUST 2013 161529379 2014-07-25 IVES HILL RETIREMENT COMMUNITY 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 812990
Sponsor’s telephone number 3157799590
Plan sponsor’s address 1200 JEWELL DRIVE, WATERTOWN, NY, 13601

Signature of
Role Plan administrator
Date 2014-07-25
Name of individual signing NIKKI REITEMA
TAX DEFERRED ANNUITY PLAN OF IVES HILL RETIREMENT COMMUNITY, INC. 2012 161529379 2013-07-30 IVES HILL RETIREMENT COMMUNITY, INC . 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-01
Business code 623000
Sponsor’s telephone number 3157799590
Plan sponsor’s address 1200 JEWELL DR, WATERTOWN, NY, 13601

Signature of
Role Plan administrator
Date 2013-07-30
Name of individual signing MEGAN TINDOLL
Role Employer/plan sponsor
Date 2013-07-30
Name of individual signing MEGAN TINDOLL
TAX DEFERRED ANNUITY PLAN OF IVES HILL RETIREMENT COMMUNITY, INC. 2010 161529379 2011-07-28 IVES HILL RETIREMENT COMMUNITY, INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-01
Business code 623000
Sponsor’s telephone number 3157799590
Plan sponsor’s address 1200 JEWELL DR, WATERTOWN, NY, 13601

Plan administrator’s name and address
Administrator’s EIN 161529379
Plan administrator’s name IVES HILL RETIREMENT COMMUNITY, INC
Plan administrator’s address 1200 JEWELL DR, WATERTOWN, NY, 13601
Administrator’s telephone number 3157799590

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing DIANNE WARD
Role Employer/plan sponsor
Date 2011-07-28
Name of individual signing DIANNE WARD
TAX DEFERRED ANNUITY PLAN OF IVES HILL RETIREMENT COMMUNITY, INC. 2009 161529379 2010-10-14 IVES HILL RETIREMENT COMMUNITY, INC . 3
Three-digit plan number (PN) 001
Effective date of plan 2001-07-01
Business code 623000
Sponsor’s telephone number 3157799590
Plan sponsor’s address 1200 JEWELL DR, WATERTOWN, NY, 13601

Plan administrator’s name and address
Administrator’s EIN 161529379
Plan administrator’s name IVES HILL RETIREMENT COMMUNITY, INC .
Plan administrator’s address 1200 JEWELL DR, WATERTOWN, NY, 13601
Administrator’s telephone number 3157799590

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 IVES HILL RETIREMENT COMMUNITY, INC. 2009 161529379 2010-10-15 IVES HILL RETIREMENT COMMUNITY, INC . 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-07-01
Business code 623000
Sponsor’s telephone number 3157799590
Plan sponsor’s address 1200 JEWELL DR, WATERTOWN, NY, 13601

Plan administrator’s name and address
Administrator’s EIN 161529379
Plan administrator’s name IVES HILL RETIREMENT COMMUNITY, INC .
Plan administrator’s address 1200 JEWELL DR, WATERTOWN, NY, 13601
Administrator’s telephone number 3157799590

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

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent P.O. BOX 632, JEWELL DRIVE, WATERTOWN, NY, United States, 13601

Filings

Filing Number Date Filed Type Effective Date
970612000373 1997-06-12 CERTIFICATE OF INCORPORATION 1997-06-12

Inspections

Date Inspection Object Address Grade Type Institution Desctiption
2025-01-28 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health 15A - Floors, walls, ceilings, not smooth, properly constructed, in disrepair, dirty surfaces
2024-08-01 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health 11D - Non food contact surfaces of equipment not clean
2024-02-16 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health 11D - Non food contact surfaces of equipment not clean
2023-09-14 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health No data
2023-01-31 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health 10A - Food (ice) contact surfaces are improperly designed, constructed, installed, located (cracks, open seams, pitted surfaces, tin cans reused, uncleanable or corroded food contact surfaces)
2022-09-29 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health 10B - Non-food contact surfaces and equipment are improperly designed, constructed, installed, maintained (equipment not readily accessible for cleaning, surface not smooth finish)
2022-04-01 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health No data
2021-10-22 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health No data
2020-02-25 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health 15A - Floors, walls, ceilings, not smooth, properly constructed, in disrepair, dirty surfaces
2019-10-15 No data 1200 JEWELL DRIVE, WATERTOWN Not Critical Violation Food Service Establishment Inspections New York State Department of Health No data

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
16-1529379 Corporation Unconditional Exemption 1200 JEWELL DR, WATERTOWN, NY, 13601-4247 1997-09
In Care of Name % DIANNE L WARD
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
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 deductible.
Foundation Organization that normally receives no more than one-third of its support from gross investment income and unrelated business income and at the same time more than one-third of its support from contributions, fees, and gross receipts related to exempt purposes 509(a)(2)
Tax Period 2023-12
Asset 10,000,000 to 49,999,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 12375114
Income Amount 2596854
Form 990 Revenue Amount 2596854
National Taxonomy of Exempt Entities Housing & Shelter: Senior Citizens' Housing/Retirement Communities
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name IVES HILL RETIREMENT COMMUNITY INC
EIN 16-1529379
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name IVES HILL RETIREMENT COMMUNITY INC
EIN 16-1529379
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name IVES HILL RETIREMENT COMMUNITY INC
EIN 16-1529379
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name IVES HILL RETIREMENT COMMUNITY INC
EIN 16-1529379
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name IVES HILL RETIREMENT COMMUNITY INC
EIN 16-1529379
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name IVES HILL RETIREMENT COMMUNITY INC
EIN 16-1529379
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name IVES HILL RETIREMENT COMMUNITY INC
EIN 16-1529379
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name IVES HILL RETIREMENT COMMUNITY INC
EIN 16-1529379
Tax Period 201512
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8606658706 2021-04-07 0248 PPP 1200 Jewell Dr, Watertown, NY, 13601-4247
Loan Status Date 2021-09-15
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 109383
Loan Approval Amount (current) 109383
Undisbursed Amount 0
Franchise Name -
Lender Location ID 19431
Servicing Lender Name The Bank of Edison
Servicing Lender Address 476 Turner St, EDISON, GA, 39846-5920
Rural or Urban Indicator R
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Watertown, JEFFERSON, NY, 13601-4247
Project Congressional District NY-24
Number of Employees 24
NAICS code 623311
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type 501(c)3 � Non Profit
Originating Lender ID 19431
Originating Lender Name The Bank of Edison
Originating Lender Address EDISON, GA
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 109659.5
Forgiveness Paid Date 2021-08-06

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Date of last update: 31 Mar 2025

Sources: New York Secretary of State

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