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  5. A. L. JACOBSEN FUNERAL HOME, INC.

A. L. JACOBSEN FUNERAL HOME, INC.

Company Details

Name: A. L. JACOBSEN FUNERAL HOME, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 09 Aug 1928 (97 years ago)
Entity Number: 25072
ZIP code: 11746
County: Suffolk
Place of Formation: New York
Address: 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, United States, 11746
Principal Address: 3 THORMAN LANE, HUNTINGTON, NY, United States, 11743

Shares Details

Shares issued 0

Share Par Value 5000

Type CAP

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
A. L. JACOBSEN FUNERAL HOME, INC. 401(K) PROFIT SHARING PLAN 2019 110915740 2020-04-10 A L JACOBSEN FUNERAL HOME INC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-05-13
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746

Signature of
Role Plan administrator
Date 2020-04-10
Name of individual signing BOB LAMONTE
A. L. JACOBSEN FUNERAL HOME, INC. 401(K) PROFIT SHARING PLAN 2018 110915740 2019-07-15 A L JACOBSEN FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-05-13
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746

Signature of
Role Plan administrator
Date 2019-07-15
Name of individual signing SHAWN FIVES
A. L. JACOBSEN FUNERAL HOME, INC. 401(K) PROFIT SHARING PLAN 2017 110915740 2018-06-11 A L JACOBSEN FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-05-13
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746

Signature of
Role Plan administrator
Date 2018-06-11
Name of individual signing SHAWN FIVES
A. L. JACOBSEN FUNERAL HOME, INC. 401(K) PROFIT SHARING PLAN 2016 110915740 2017-06-22 A L JACOBSEN FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-05-13
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746

Signature of
Role Plan administrator
Date 2017-06-22
Name of individual signing SHAWN FIVES
A. L. JACOBSEN FUNERAL HOME, INC. 401(K) PROFIT SHARING PLAN 2015 110915740 2016-06-29 A L JACOBSEN FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-05-13
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746

Signature of
Role Plan administrator
Date 2016-06-29
Name of individual signing SHAWN FIVES
A. L. JACOBSEN FUNERAL HOME, INC. 401(K) PROFIT SHARING PLAN 2014 110915740 2015-05-28 A L JACOBSEN FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-05-13
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746

Signature of
Role Plan administrator
Date 2015-05-28
Name of individual signing SHAWN FIVES
A. L. JACOBSEN FUNERAL HOME, INC. 401(K) PROFIT SHARING PLAN 2013 110915740 2014-06-26 A L JACOBSEN FUNERAL HOME INC 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-05-13
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746

Signature of
Role Plan administrator
Date 2014-06-26
Name of individual signing SHAWN FIVES
A L JACOBSEN FUNERAL HOME INC 401K PLAN 2011 110915740 2012-10-01 A L JACOBSEN FUNERAL HOME INC 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-05-13
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, ATTN CHRISTIAN JACOBSEN, HUNTINGTON STATION, NY, 11746

Plan administrator’s name and address
Administrator’s EIN 110915740
Plan administrator’s name A L JACOBSEN FUNERAL HOME INC
Plan administrator’s address 1380 NEW YORK AVENUE, ATTN CHRISTIAN JACOBSEN, HUNTINGTON STATION, NY, 11746
Administrator’s telephone number 6314232185

Signature of
Role Plan administrator
Date 2012-10-01
Name of individual signing CHRISTIAN JACOBSEN
A. L. JACOBSEN FUNERAL HOME, INC. 401(K) PROFIT SHARING PLAN 2010 110915740 2011-10-04 A. L. JACOBSEN FUNERAL HOME, INC. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1996-01-01
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746

Plan administrator’s name and address
Administrator’s EIN 110915740
Plan administrator’s name A. L. JACOBSEN FUNERAL HOME, INC.
Plan administrator’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746
Administrator’s telephone number 6314232185

Signature of
Role Plan administrator
Date 2011-08-18
Name of individual signing CHRISTIAN K. JACOBSEN
A. L. JACOBSEN FUNERAL HOME, INC. 401(K) PROFIT SHARING PLAN 2010 110915740 2011-08-18 A. L. JACOBSEN FUNERAL HOME, INC. 10
Three-digit plan number (PN) 002
Effective date of plan 1996-01-01
Business code 812210
Sponsor’s telephone number 6314232185
Plan sponsor’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746

Plan administrator’s name and address
Administrator’s EIN 110915740
Plan administrator’s name A. L. JACOBSEN FUNERAL HOME, INC.
Plan administrator’s address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746
Administrator’s telephone number 6314232185

Signature of
Role Plan administrator
Date 2011-08-18
Name of individual signing CHRISTIAN K. JACOBSEN

Chief Executive Officer

Name Role Address
CHRISTIAN K JACOBSEN Chief Executive Officer 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, United States, 11746

DOS Process Agent

Name Role Address
CHRISTIAN K JACOBSEN DOS Process Agent 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, United States, 11746

History

Start date End date Type Value
1995-02-02 1998-07-20 Address 1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, 11746, USA (Type of address: Principal Executive Office)
1928-08-09 1995-02-02 Address NO STREET ADDRESS, HUNTINGTON, NY, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
060825002338 2006-08-25 BIENNIAL STATEMENT 2006-08-01
020722002667 2002-07-22 BIENNIAL STATEMENT 2002-08-01
000907002003 2000-09-07 BIENNIAL STATEMENT 2000-08-01
980720002246 1998-07-20 BIENNIAL STATEMENT 1998-08-01
960815002693 1996-08-15 BIENNIAL STATEMENT 1996-08-01
950202002064 1995-02-02 BIENNIAL STATEMENT 1993-08-01
C202827-2 1993-09-02 ASSUMED NAME CORP INITIAL FILING 1993-09-02
B338989-3 1986-03-27 CERTIFICATE OF AMENDMENT 1986-03-27
880698-3 1971-01-08 CERTIFICATE OF AMENDMENT 1971-01-08
3353-65 1928-08-09 CERTIFICATE OF INCORPORATION 1928-08-09

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
102879806 0214700 1996-05-31 1380 NEW YORK AVE, HUNTINGTON STATION, NY, 11746
Inspection Type Prog Other
Scope Complete
Safety/Health Health
Close Conference 1996-06-12
Case Closed 1996-10-01

Violation Items
Citation ID 01001
Citaton Type Other
Standard Cited 19040002 A
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Gravity 00
Citation ID 01002A
Citaton Type Other
Standard Cited 19100132 A
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Citation ID 01002B
Citaton Type Other
Standard Cited 19100132 F04
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Citation ID 01003A
Citaton Type Other
Standard Cited 19101030 C01 IIB
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Citation ID 01003B
Citaton Type Other
Standard Cited 19101030 C01 IIB
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Citation ID 01003C
Citaton Type Other
Standard Cited 19101030 C01 IIB
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Citation ID 01003D
Citaton Type Other
Standard Cited 19101030 C01 IIB
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Citation ID 01003E
Citaton Type Other
Standard Cited 19101030 C01 IIC
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Citation ID 01004
Citaton Type Other
Standard Cited 19101030 G02 IIC
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Citation ID 01005
Citaton Type Other
Standard Cited 19101030 H01 I
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5
Citation ID 01006
Citaton Type Other
Standard Cited 19101048 D01 III
Issuance Date 1996-07-30
Abatement Due Date 1996-08-02
Nr Instances 1
Nr Exposed 5
Citation ID 01007
Citaton Type Other
Standard Cited 19101048 O01
Issuance Date 1996-07-30
Abatement Due Date 1996-09-16
Nr Instances 1
Nr Exposed 5

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6041178010 2020-06-29 0235 PPP 1380 New York Avenue, Huntington Station, NY, 11746-1703
Loan Status Date 2021-08-19
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 75032
Loan Approval Amount (current) 75032
Undisbursed Amount 0
Franchise Name -
Lender Location ID 456756
Servicing Lender Name Cross River Bank
Servicing Lender Address 885 Teaneck Rd, TEANECK, NJ, 07666-4546
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Unanswered
Project Address Huntington Station, SUFFOLK, NY, 11746-1703
Project Congressional District NY-01
Number of Employees 7
NAICS code 541990
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 456756
Originating Lender Name Cross River Bank
Originating Lender Address TEANECK, NJ
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 75796.71
Forgiveness Paid Date 2021-07-08

Related by officers

No related officers

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1380 NEW YORK AVENUE, HUNTINGTON STATION, NY, United States, 11746

5 HAVENWOOD DRIVE, LLC VIRAG - MADDEX FUNERAL DIRECTORS, INC.

Date of last update: 19 Mar 2025

Sources: New York Secretary of State

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