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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

Date of last update: 21 Jan 2025

Sources: New York Secretary of State