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  5. LUTHERAN SOCIAL SERVICES GROUP, INC.

LUTHERAN SOCIAL SERVICES GROUP, INC.

Company Details

Name: LUTHERAN SOCIAL SERVICES GROUP, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 20 Feb 1998 (27 years ago)
Entity Number: 2231088
ZIP code: 14701
County: Chautauqua
Place of Formation: New York
Address: 715 falconer street, JAMESTOWN, NY, United States, 14701

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
YOURWAY HRA BENEFIT PLAN OF LUTHERAN SOCIAL SERVICES GROUP INC. 2023 161548940 2024-08-15 LUTHERAN SOCIAL SERVICES GROUP INC. 96
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2022-01-01
Business code 623000
Sponsor’s telephone number 7166658147
Plan sponsor’s address 715 FALCONER ST, JAMESTOWN, NY, 14701

Signature of
Role Plan administrator
Date 2024-08-15
Name of individual signing JASON BECKWITH
YOURWAY HRA BENEFIT PLAN OF LUTHERAN SOCIAL SERVICES GROUP INC. 2022 161548940 2023-09-28 LUTHERAN SOCIAL SERVICES GROUP INC. 93
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2022-01-01
Business code 623000
Sponsor’s telephone number 7166658147
Plan sponsor’s address 715 FALCONER ST, JAMESTOWN, NY, 14701

Signature of
Role Plan administrator
Date 2023-09-25
Name of individual signing KELLIE MOLE
LUTHERAN SOCIAL SERVICES GROUP, INC. HEALTH AND WELFARE BENEFITS PLAN 2020 161548940 2021-07-13 LUTHERAN SOCIAL SERVICES GROUP, INC. 374
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1972-06-15
Business code 623000
Sponsor’s telephone number 7166658147
Plan sponsor’s mailing address 715 FALCONER STREET, JAMESTOWN, NY, 14701
Plan sponsor’s address 715 FALCONER STREET, JAMESTOWN, NY, 14701

Number of participants as of the end of the plan year
Active participants 216
Retired or separated participants receiving benefits 7

Signature of
Role Plan administrator
Date 2021-07-13
Name of individual signing LYNNETTE REALE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-13
Name of individual signing LYNNETTE REALE
Valid signature Filed with authorized/valid electronic signature
LUTHERAN SOCIAL SERVICES GROUP, INC. HEALTH AND WELFARE BENEFITS PLAN 2019 161548940 2020-07-23 LUTHERAN SOCIAL SERVICES GROUP, INC. 385
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1972-06-15
Business code 623000
Sponsor’s telephone number 7166658147
Plan sponsor’s mailing address 715 FALCONER ST, JAMESTOWN, NY, 147011935
Plan sponsor’s address 715 FALCONER ST, JAMESTOWN, NY, 147011935

Number of participants as of the end of the plan year
Active participants 369
Retired or separated participants receiving benefits 6

Signature of
Role Plan administrator
Date 2020-07-23
Name of individual signing LYNNETTE REALE
Valid signature Filed with authorized/valid electronic signature
LUTHERAN SOCIAL SERVICES GROUP, INC, HEALTH AND WELFARE BENEFITS PLAN 2018 161548940 2019-07-30 LUTHERAN SOCIAL SERVICES GROUP, INC 403
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1972-06-15
Business code 623000
Sponsor’s telephone number 7166658147
Plan sponsor’s mailing address 715 FALCONER STREET, JAMESTOWN, NY, 14701
Plan sponsor’s address 715 FALCONER STREET, JAMESTOWN, NY, 14701

Number of participants as of the end of the plan year
Active participants 388
Retired or separated participants receiving benefits 4

Signature of
Role Plan administrator
Date 2019-07-30
Name of individual signing LYNNETTE REALE
Valid signature Filed with authorized/valid electronic signature
LUTHERAN SOCIAL SERVICES GROUP, INC. HEALTH AND WELFARE BENEFITS PLAN 2017 161548940 2018-07-27 LUTHERAN SOCIAL SERVICES GROUP, INC 412
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1972-06-15
Business code 623000
Sponsor’s telephone number 7166658147
Plan sponsor’s mailing address 715 FALCONER STREET, JAMESTOWN, NY, 14701
Plan sponsor’s address 715 FALCONER STREET, JAMESTOWN, NY, 14701

Number of participants as of the end of the plan year
Active participants 409
Retired or separated participants receiving benefits 3

Signature of
Role Plan administrator
Date 2018-07-27
Name of individual signing LYNNETTE REALE
Valid signature Filed with authorized/valid electronic signature
LUTHERAN SOCIAL SERVICES GROUP, INC. HEALTH AND WELFARE BENEFITS PLAN 2016 161548940 2017-07-20 LUTHERAN SOCIAL SERVICES GROUP, INC. 412
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1972-06-15
Business code 623000
Sponsor’s telephone number 7166658147
Plan sponsor’s mailing address 715 FALCONER STREET, JAMESTOWN, NY, 14701
Plan sponsor’s address 715 FALCONER STREET, JAMESTOWN, NY, 14701

Number of participants as of the end of the plan year
Active participants 410
Retired or separated participants receiving benefits 6

Signature of
Role Plan administrator
Date 2017-07-20
Name of individual signing LYNNETTE REALE
Valid signature Filed with authorized/valid electronic signature
LUTHERAN SOCIAL SERVICES GROUP, INC, HEALTH AND WELFARE BENEFITS PLAN 2015 161548940 2016-07-28 LUTHERAN SOCIAL SERVICES GROUP, INC 421
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1972-06-15
Business code 623000
Sponsor’s telephone number 7166658147
Plan sponsor’s mailing address 715 FALCONER STREET, JAMESTOWN, NY, 14701
Plan sponsor’s address 715 FALCONER STREET, JAMESTOWN, NY, 14701

Number of participants as of the end of the plan year
Active participants 408
Retired or separated participants receiving benefits 11

Signature of
Role Plan administrator
Date 2016-07-28
Name of individual signing LYNNETTE REALE
Valid signature Filed with authorized/valid electronic signature
LUTHERAN SOCIAL SERVICES GROUP, INC. HEALTH AND WELFARE BENEFITS PLAN 2014 161548940 2015-07-31 LUTHERAN SOCIAL SERVICES GROUP, INC 415
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1972-06-15
Business code 623000
Sponsor’s telephone number 7166658147
Plan sponsor’s mailing address 715 FALCONER STREET, JAMESTOWN, NY, 14701
Plan sponsor’s address 715 FALCONER STREET, JAMESTOWN, NY, 14701

Number of participants as of the end of the plan year
Active participants 427
Retired or separated participants receiving benefits 7

Signature of
Role Plan administrator
Date 2015-07-31
Name of individual signing LYNNETTE REALE
Valid signature Filed with authorized/valid electronic signature
LUTHERAN SOCIAL SERVICES GROUP, INC. HEALTH AND WELFARE BENEFITS PLAN 2012 161548940 2013-07-11 LUTHERAN SOCIAL SERVICES GROUP, INC 410
Three-digit plan number (PN) 502
Effective date of plan 1972-06-15
Business code 623000
Sponsor’s telephone number 7166654905
Plan sponsor’s mailing address 715 FALCONER STREET, JAMESTOWN, NY, 14701
Plan sponsor’s address 715 FALCONER STREET, JAMESTOWN, NY, 14701

Number of participants as of the end of the plan year
Active participants 406
Retired or separated participants receiving benefits 6
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Employer/plan sponsor
Date 2013-07-11
Name of individual signing KATRINA JONES
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
the corporation DOS Process Agent 715 falconer street, JAMESTOWN, NY, United States, 14701

Agent

Name Role Address
chief executive officer Agent 715 FALCONER STREET, JAMESTOWN, NY, 14701

History

Start date End date Type Value
1998-02-20 2022-11-13 Address 307 CHASE BANK BUILDING, P.O. BOX 1279, JAMESTOWN, NY, 14702, 1279, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
221113000216 2022-11-11 CERTIFICATE OF CHANGE BY ENTITY 2022-11-11
980220000758 1998-02-20 CERTIFICATE OF INCORPORATION 1998-02-20

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
16-1548940 Corporation Unconditional Exemption 715 FALCONER ST, JAMESTOWN, NY, 14701-1935 1988-04
In Care of Name % THOMAS HOLT
Group Exemption Number 9386
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 Subordinate - This code is used if the organization is a subordinate in a group ruling.
Classification Religious Organization
Deductibility Contributions are deductible.
Foundation Church 170(b)(1)(A)(i)
Tax Period 2023-12
Asset 1,000,000 to 4,999,999
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 2461780
Income Amount 1920503
Form 990 Revenue Amount 1920503
National Taxonomy of Exempt Entities -
Sort Name -

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name LUTHERAN SOCIAL SERVICES GROUP INC
EIN 16-1548940
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name LUTHERAN SOCIAL SERVICES GROUP INC
EIN 16-1548940
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name LUTHERAN SOCIAL SERVICES GROUP INC
EIN 16-1548940
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name LUTHERAN SOCIAL SERVICES GROUP INC
EIN 16-1548940
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name LUTHERAN SOCIAL SERVICES GROUP INC
EIN 16-1548940
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name LUTHERAN SOCIAL SERVICES GROUP INC
EIN 16-1548940
Tax Period 201512
Filing Type E
Return Type 990
File View File
91-2101156 Corporation Unconditional Exemption 715 FALCONER ST, JAMESTOWN, NY, 14701-1935 1987-04
In Care of Name -
Group Exemption Number 9386
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 Subordinate - This code is used if the organization is a subordinate in a group ruling.
Classification Religious Organization
Deductibility Contributions are deductible.
Foundation Church 170(b)(1)(A)(i)
Tax Period -
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 - Not required to file (church)
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount -
Income Amount -
Form 990 Revenue Amount -
National Taxonomy of Exempt Entities -
Sort Name GROUP RETURN

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9227508908 2021-05-12 0296 PPS 715 Falconer St, Jamestown, NY, 14701-1935
Loan Status Date 2021-06-25
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 2000000
Loan Approval Amount (current) 2000000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 445285
Servicing Lender Name BOC Capital Corportion
Servicing Lender Address 85 S. Oxford Street, Brooklyn, NY, 11217
Rural or Urban Indicator R
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Jamestown, CHAUTAUQUA, NY, 14701-1935
Project Congressional District NY-23
Number of Employees 300
NAICS code 623110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 445285
Originating Lender Name BOC Capital Corportion
Originating Lender Address Brooklyn, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 2012666.67
Forgiveness Paid Date 2022-01-12
7564267108 2020-04-14 0296 PPP 715 Falconer Street, Jamestown, NY, 14701
Loan Status Date 2021-10-09
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 2936140
Loan Approval Amount (current) 2936140
Undisbursed Amount 0
Franchise Name -
Lender Location ID 46391
Servicing Lender Name Manufacturers and Traders Trust Company
Servicing Lender Address One M & T Plaza, 15th Fl, BUFFALO, NY, 14203
Rural or Urban Indicator R
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Jamestown, CHAUTAUQUA, NY, 14701-0019
Project Congressional District NY-23
Number of Employees 320
NAICS code 623110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 46391
Originating Lender Name Manufacturers and Traders Trust Company
Originating Lender Address BUFFALO, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 2974189.16
Forgiveness Paid Date 2021-08-09

Motor Carrier Census

USDOT Number Carrier Operation MCS-150 Form Date MCS-150 Mileage MCS-150 Year Power Units Drivers Operation Classification
1595150 Intrastate Non-Hazmat 2007-01-12 30000 2006 3 6 Private(Property)
Legal Name LUTHERAN SOCIAL SERVICES GROUP INC
DBA Name -
Physical Address 715 FALCONER ST, JAMESTOWN, NY, 14701, US
Mailing Address 715 FALCONER ST, JAMESTOWN, NY, 14701, US
Phone (716) 483-8063
Fax (716) 665-8059
E-mail -

Safety Measurement System - All Transportation
Total Number of Inspections for the measurement period (24 months) 0
Driver Fitness BASIC Serious Violation Indicator No
Vehicle Maintenance BASIC Acute/Critical Indicator No
Unsafe Driving BASIC Acute/Critical Indicator No
Driver Fitness BASIC Roadside Performance measure value 0
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value 0
Total Number of Driver Inspections for the measurment period 0
Vehicle Maintenance BASIC Roadside Performance measure value 0
Total Number of Vehicle Inspections for the measurement period 0
Controlled Substances and Alcohol BASIC Roadside Performance measure value 0
Unsafe Driving BASIC Roadside Performance Measure Value 0
Number of inspections with at least one Driver Fitness BASIC violation 0
Number of inspections with at least one Hours-of-Service BASIC violation 0
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation 0
Number of inspections with at least one Vehicle Maintenance BASIC violation 0
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation 0
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation 0
Number of inspections with at least one Unsafe Driving BASIC violation 0

Related by officers

the corporation

SHERMAN V. ALLEN, INC. SENSUAL EXPRESSIONS INC. BRIGHT INSIGHTS GLOBAL LABS FOR GOOD, INC. WATAN DUAL EDUCATION, INC. NAYO CARES, INC. RENEGADE SOFTBALL CLUB, INC. CFLO INC. BANGLADESHI AMERICAN COMMUNITY SERVICES, INC. TRISP FOUNDATION, INC. THE LILAC HOUSE INC.

chief executive officer

INTEGRITY PARTNERS FOR BEHAVIORAL HEALTH IPA, INC. GUSTAVUS ADOLPHUS CHILD & FAMILY SERVICES, INC.

Related by address

715 falconer street, JAMESTOWN, NY, United States, 14701

GRACE LUTHERAN RESIDENTIAL SERVICES, INC. GUSTAVUS ADOLPHUS CHILD & FAMILY SERVICES, INC. LUTHERAN HOUSING ADMINISTRATIVE SERVICES GROUP, INC. LUTHERAN SOCIAL SERVICES FOUNDATION OF UPSTATE NEW YORK, INC.

Date of last update: 31 Mar 2025

Sources: New York Secretary of State

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