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  5. BROOKS-TLC HOSPITAL SYSTEM, INC.

BROOKS-TLC HOSPITAL SYSTEM, INC.

Company Details

Name: BROOKS-TLC HOSPITAL SYSTEM, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 18 Jul 1898 (127 years ago)
Entity Number: 22890
ZIP code: 14048
County: Chautauqua
Place of Formation: New York
Address: 529 CENTRAL AVE., DUNKIRK, NY, United States, 14048

Contact Details

Phone +1 716-338-9797

Phone +1 716-532-8100

Phone +1 716-947-0316

Phone +1 716-595-3355

Phone +1 716-934-2654

Phone +1 716-965-9738

Phone +1 716-951-7000

Phone +1 716-947-1101

Phone +1 716-366-1111

Phone +1 716-532-3377

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
LN3DT9C89CU5 2024-12-13 529 CENTRAL AVE, DUNKIRK, NY, 14048, 2514, USA 529 CENTRAL AVE, DUNKIRK, NY, 14048, 2514, USA

Business Information
Division Name BROOKS-TLC HOSPITAL SYSTEM, INC
Division Number 01
Congressional District 23
State/Country of Incorporation NY, USA
Activation Date 2023-12-18
Initial Registration Date 2014-04-17
Entity Start Date 1885-04-01
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name JULIE CROSS
Role EXECUTIVE ASSISTANT
Address 529 CENTRAL AVE, DUNKIRK, NY, 14048, USA
Title ALTERNATE POC
Name KENNETH MORRIS
Role COO
Address 529 CENTRAL AVE, DUNKIRK, NY, 14048, USA
Government Business
Title PRIMARY POC
Name JULIE CROSS
Role EXECUTIVE ASSISTANT
Address 529 CENTRAL AVE, DUNKIRK, NY, 14048, USA
Title ALTERNATE POC
Name KENNETH MORRIS
Role COO
Address 529 CENTRAL AVE, DUNKIRK, NY, 14048, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
73R14 Obsolete Non-Manufacturer 2014-04-21 2024-10-29 No data 2025-10-28

Contact Information
POC JULIE CROSS
Phone +1 716-363-7207
Address 529 CENTRAL AVE, DUNKIRK, NY, 14048 2514, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TLC HEALTH NETWORK TAX DEFERRED ANNUITY PENSION PLAN 2023 160743301 2024-09-18 BROOKS - TLC HOSPITAL SYSTEM, INC 31
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1964-07-01
Business code 622000
Sponsor’s telephone number 7163637263
Plan sponsor’s address 529 CENTRAL AVENUE, DUNKIRK, NY, 14081

Signature of
Role Plan administrator
Date 2024-09-18
Name of individual signing TRACIE LUTHER
Valid signature Filed with authorized/valid electronic signature
BROOKS-TLC HOSPITAL SYSTEM, INC. NON-UNION EMPLOYEES PENSION PLAN 2023 160743301 2024-10-01 BROOKS-TLC HOSPITAL SYSTEM, INC. 116
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1993-01-01
Business code 622000
Sponsor’s telephone number 7163627207
Plan sponsor’s address 529 CENTRAL AVE, DUNKIRK, NY, 140482514

Signature of
Role Plan administrator
Date 2024-10-01
Name of individual signing TRACIE LUTHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-01
Name of individual signing TRACIE LUTHER
Valid signature Filed with authorized/valid electronic signature
TLC HEALTH NETWORK EXECUTIVE MANAGEMENT PLAN 2023 160772474 2024-10-08 BROOKS-TLC HOSPITAL SYSTEM, INC. 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 622000
Sponsor’s telephone number 7163637263
Plan sponsor’s address 529 CENTRAL AVENUE, DUNKIRK, NY, 14048
TLC HEALTH NETWORK TAX DEFERRED ANNUITY PENSION PLAN 2022 160743301 2023-08-02 BROOKS - TLC HOSPITAL SYSTEM, INC 33
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1964-07-01
Business code 622000
Sponsor’s telephone number 7163637263
Plan sponsor’s address 529 CENTRAL AVENUE, DUNKIRK, NY, 14081

Signature of
Role Plan administrator
Date 2023-08-02
Name of individual signing TRACIE LUTHER
TLC HEALTH NETWORK EXECUTIVE MANAGEMENT PLAN 2022 160772474 2023-08-15 BROOKS-TLC HOSPITAL SYSTEM, INC. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 622000
Sponsor’s telephone number 7163637263
Plan sponsor’s address 529 CENTRAL AVENUE, DUNKIRK, NY, 14048
BROOKS-TLC HOSPITAL SYSTEM, INC. NON-UNION EMPLOYEES PENSION PLAN 2022 160743301 2023-09-21 BROOKS-TLC HOSPITAL SYSTEM, INC. 115
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1993-01-01
Business code 622000
Sponsor’s telephone number 7163627207
Plan sponsor’s address 529 CENTRAL AVE, DUNKIRK, NY, 140482514

Signature of
Role Plan administrator
Date 2023-09-21
Name of individual signing TRACIE LUTHER
Role Employer/plan sponsor
Date 2023-09-21
Name of individual signing TRACIE LUTHER
TLC HEALTH NETWORK EXECUTIVE MANAGEMENT PLAN 2021 160772474 2022-10-05 BROOKS-TLC HOSPITAL SYSTEM, INC. 4
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 622000
Sponsor’s telephone number 7163637263
Plan sponsor’s address 529 CENTRAL AVENUE, DUNKIRK, NY, 14048
TLC HEALTH NETWORK TAX DEFERRED ANNUITY PENSION PLAN 2021 160743301 2022-03-01 BROOKS - TLC HOSPITAL SYSTEM, INC 17
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1964-07-01
Business code 622000
Sponsor’s telephone number 7163637263
Plan sponsor’s address 529 CENTRAL AVENUE, DUNKIRK, NY, 14081

Signature of
Role Plan administrator
Date 2022-03-01
Name of individual signing TRACIE LUTHER
BROOKS-TLC HOSPITAL SYSTEM, INC. NON-UNION EMPLOYEES PENSION PLAN 2021 160743301 2022-10-06 BROOKS-TLC HOSPITAL SYSTEM, INC. 115
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1993-01-01
Business code 622000
Sponsor’s telephone number 7163627207
Plan sponsor’s address 529 CENTRAL AVE, DUNKIRK, NY, 140482514

Signature of
Role Plan administrator
Date 2022-10-06
Name of individual signing TRACIE LUTHER
Role Employer/plan sponsor
Date 2022-10-06
Name of individual signing TRACIE LUTHER
TLC HEALTH NETWORK TAX DEFERRED ANNUITY PENSION PLAN 2020 160743301 2021-10-14 BROOKS - TLC HOSPITAL SYSTEM, INC 17
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1964-07-01
Business code 622000
Sponsor’s telephone number 7163637263
Plan sponsor’s address 529 CENTRAL AVENUE, DUNKIRK, NY, 14081

Signature of
Role Plan administrator
Date 2021-10-14
Name of individual signing TRACIE LUTHER

DOS Process Agent

Name Role Address
BROOKS-TLC HOSPITAL SYSTEM, INC. DOS Process Agent 529 CENTRAL AVE., DUNKIRK, NY, United States, 14048

History

Start date End date Type Value
2008-12-03 2018-04-17 Address 529 CENTRAL AVE., DUNKIRK, NY, 14048, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
180417000794 2018-04-17 CERTIFICATE OF AMENDMENT 2018-04-17
180220000946 2018-02-20 CERTIFICATE OF MERGER 2018-02-20
180220000940 2018-02-20 CERTIFICATE OF MERGER 2018-02-20
081203000173 2008-12-03 CERTIFICATE OF AMENDMENT 2008-12-03
C224445-2 1995-06-29 ASSUMED NAME CORP INITIAL FILING 1995-06-29
A433887-2 1977-10-06 CERTIFICATE OF ANNULMENT OF DISSOLUTION AND REINSTATEMENT OF CORPORATE EXISTENCE 1977-10-06
DP-626 1952-10-15 DISSOLUTION BY PROCLAMATION 1952-10-15
483Q-100 1947-05-19 CERTIFICATE OF AMENDMENT 1947-05-19
29Q-112 1898-07-18 CERTIFICATE OF INCORPORATION 1898-07-18

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
16-0743301 Corporation Unconditional Exemption 529 CENTRAL AVE, DUNKIRK, NY, 14048-2514 1949-11
In Care of Name -
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 Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-12
Asset 10,000,000 to 49,999,999
Income 50,000,000 to greater
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 49627640
Income Amount 68898182
Form 990 Revenue Amount 68875844
National Taxonomy of Exempt Entities -
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 BROOKS-TLC HOSPITAL SYSTEM
EIN 16-0743301
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM
EIN 16-0743301
Tax Period 202212
Filing Type E
Return Type 990T
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM
EIN 16-0743301
Tax Period 202112
Filing Type E
Return Type 990T
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM
EIN 16-0743301
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM
EIN 16-0743301
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM
EIN 16-0743301
Tax Period 202012
Filing Type E
Return Type 990T
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM
EIN 16-0743301
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM
EIN 16-0743301
Tax Period 201912
Filing Type P
Return Type 990T
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM INC
EIN 16-0743301
Tax Period 201812
Filing Type P
Return Type 990
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM INC
EIN 16-0743301
Tax Period 201812
Filing Type P
Return Type 990T
File View File
Organization Name BROOKS-TLC HOSPITAL SYSTEM INC
EIN 16-0743301
Tax Period 201812
Filing Type P
Return Type 990T
File View File
Organization Name BROOKS MEMORIAL HOSPITAL
EIN 16-0743301
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name BROOKS MEMORIAL HOSPITAL
EIN 16-0743301
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name BROOKS MEMORIAL HOSPITAL
EIN 16-0743301
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
4194777204 2020-04-27 0296 PPP 529 CENTRAL AVE, DUNKIRK, NY, 14048-2514
Loan Status Date 2021-08-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 4080721
Loan Approval Amount (current) 4080721
Undisbursed Amount 0
Franchise Name -
Lender Location ID 89165
Servicing Lender Name Lake Shore Savings Bank
Servicing Lender Address 128 E 4th St, DUNKIRK, NY, 14048-2226
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address DUNKIRK, CHAUTAUQUA, NY, 14048-2514
Project Congressional District NY-23
Number of Employees 344
NAICS code 622110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 89165
Originating Lender Name Lake Shore Savings Bank
Originating Lender Address DUNKIRK, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 4133203.61
Forgiveness Paid Date 2021-08-09

Related by officers

No related officers

Related by address

529 CENTRAL AVE., DUNKIRK, NY, United States, 14048

LAKE ERIE MEDICAL SERVICES, P.C.

Date of last update: 19 Mar 2025

Sources: New York Secretary of State

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