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CLAIMS SERVICE BUREAU OF NEW YORK INC.

Company Details

Name: CLAIMS SERVICE BUREAU OF NEW YORK INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 02 Jan 1973 (52 years ago)
Entity Number: 250046
ZIP code: 11563
County: New York
Place of Formation: New York
Address: 21 HEMPSTEAD AVENUE, LYNBROOK, NY, United States, 11563

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLAIMS SERVICE BUREAU OF NEW YORK, INC. EMPLOYEES' PROFIT SHARING PLAN 2012 112287784 2013-06-07 CLAIMS SERVICE BUREAU OF NEW YORK, INC. 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-01-01
Business code 524290
Sponsor’s telephone number 5165932440
Plan sponsor’s mailing address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
Plan sponsor’s address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112287784
Plan administrator’s name CLAIMS SERVICE BUREAU OF NEW YORK, INC.
Plan administrator’s address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165932440

Number of participants as of the end of the plan year

Active participants 31
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 4
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 35
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2013-06-07
Name of individual signing DAVID HUTCHINSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-07
Name of individual signing DAVID HUTCHINSON
Valid signature Filed with authorized/valid electronic signature
CLAIMS SERVICE BUREAU OF NEW YORK, INC. EMPLOYEES' PROFIT SHARING PLAN 2011 112287784 2012-05-02 CLAIMS SERVICE BUREAU OF NEW YORK, INC. 37
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-01-01
Business code 524290
Sponsor’s telephone number 5165932440
Plan sponsor’s mailing address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
Plan sponsor’s address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112287784
Plan administrator’s name CLAIMS SERVICE BUREAU OF NEW YORK, INC.
Plan administrator’s address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165932440

Number of participants as of the end of the plan year

Active participants 34
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 4
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 35
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2

Signature of

Role Plan administrator
Date 2012-05-02
Name of individual signing DAVID HUTCHINSON
Valid signature Filed with authorized/valid electronic signature
CLAIMS SERVICE BUREAU OF NEW YORK, INC. EMPLOYEES' PROFIT SHARING PLAN 2010 112287784 2011-06-08 CLAIMS SERVICE BUREAU OF NEW YORK, INC. 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-01-01
Business code 524290
Sponsor’s telephone number 5165932440
Plan sponsor’s mailing address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
Plan sponsor’s address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112287784
Plan administrator’s name CLAIMS SERVICE BUREAU OF NEW YORK, INC.
Plan administrator’s address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165932440

Number of participants as of the end of the plan year

Active participants 31
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 5
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 37
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2011-06-08
Name of individual signing DAVID HUTCHINSON
Valid signature Filed with authorized/valid electronic signature
CLAIMS SERVICE BUREAU OF NEW YORK, INC. EMPLOYEES' PROFIT SHARING PLAN 2009 112287784 2010-06-02 CLAIMS SERVICE BUREAU OF NEW YORK, INC. 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-01-01
Business code 524290
Sponsor’s telephone number 5165932440
Plan sponsor’s mailing address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
Plan sponsor’s address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563

Plan administrator’s name and address

Administrator’s EIN 112287784
Plan administrator’s name CLAIMS SERVICE BUREAU OF NEW YORK, INC.
Plan administrator’s address 21 HEMPSTEAD AVENUE, LYNBROOK, NY, 11563
Administrator’s telephone number 5165932440

Number of participants as of the end of the plan year

Active participants 34
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 3
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 37
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of

Role Plan administrator
Date 2010-06-02
Name of individual signing DAVID HUTCHINSON
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
DAVID HUTCHINSON Chief Executive Officer 21 HEMPSTEAD AVENUE, LYNBROOK, NY, United States, 11563

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 21 HEMPSTEAD AVENUE, LYNBROOK, NY, United States, 11563

History

Start date End date Type Value
2024-04-26 2024-04-26 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-02-12 2024-04-26 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-02-12 2024-02-12 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-12-26 2024-02-12 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-05-31 2023-12-26 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-04-28 2023-05-31 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-03-16 2023-04-28 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-02-27 2023-03-16 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-01-13 2023-02-27 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2022-10-12 2023-01-13 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
210104060798 2021-01-04 BIENNIAL STATEMENT 2021-01-01
170104006882 2017-01-04 BIENNIAL STATEMENT 2017-01-01
150102006695 2015-01-02 BIENNIAL STATEMENT 2015-01-01
130109006847 2013-01-09 BIENNIAL STATEMENT 2013-01-01
110114003279 2011-01-14 BIENNIAL STATEMENT 2011-01-01
081223003076 2008-12-23 BIENNIAL STATEMENT 2009-01-01
070104002127 2007-01-04 BIENNIAL STATEMENT 2007-01-01
050204002272 2005-02-04 BIENNIAL STATEMENT 2005-01-01
030103002116 2003-01-03 BIENNIAL STATEMENT 2003-01-01
010111002240 2001-01-11 BIENNIAL STATEMENT 2001-01-01

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5855817707 2020-05-01 0235 PPP 21 HEMPSTEAD AVE, LYNBROOK, NY, 11563-1646
Loan Status Date 2021-10-16
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 523426
Loan Approval Amount (current) 523426
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description New Business or 2 years or less
Project Address LYNBROOK, NASSAU, NY, 11563-1646
Project Congressional District NY-04
Number of Employees 32
NAICS code 524291
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 530653.58
Forgiveness Paid Date 2021-09-23
9583748503 2021-03-12 0235 PPS 21 Hempstead Ave, Lynbrook, NY, 11563-1646
Loan Status Date 2022-03-18
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 523425
Loan Approval Amount (current) 523425
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Lynbrook, NASSAU, NY, 11563-1646
Project Congressional District NY-04
Number of Employees 28
NAICS code 524291
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 528071.29
Forgiveness Paid Date 2022-02-03

Date of last update: 01 Mar 2025

Sources: New York Secretary of State