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PENN YAN MANOR NURSING HOME, INC.

Company Details

Name: PENN YAN MANOR NURSING HOME, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 13 May 1969 (56 years ago)
Entity Number: 276719
County: Yates
Place of Formation: New York

Contact Details

Phone +1 315-536-2311

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PENN YAN MANOR NURSING HOME, INC. 401(K) PROFIT SHARING PLAN 2023 611799794 2024-06-03 PENN YAN MANOR NURSING HOME, INC. 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 NORTH LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2024-06-03
Name of individual signing JESSICA FISH
Role Employer/plan sponsor
Date 2024-06-03
Name of individual signing JESSICA FISH
PENN YAN MANOR NURSING HOME, INC. 401(K) PROFIT SHARING PLAN 2022 160967993 2023-04-11 PENN YAN MANOR NURSING HOME, INC. 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 NORTH LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2023-04-11
Name of individual signing JESSICA FISH
Role Employer/plan sponsor
Date 2023-04-11
Name of individual signing JESSICA FISH
PENN YAN MANOR NURSING HOME, INC. 401(K) PROFIT SHARING PLAN 2021 160967993 2022-06-02 PENN YAN MANOR NURSING HOME, INC. 72
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 NORTH LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2022-06-02
Name of individual signing JESSICA FISH
Role Employer/plan sponsor
Date 2022-06-02
Name of individual signing JESSICA FISH
PENN YAN MANOR NURSING HOME, INC. 401(K) PROFIT SHARING PLAN 2020 160967993 2021-03-15 PENN YAN MANOR NURSING HOME, INC. 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 N. LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2021-03-15
Name of individual signing JESSICA FISH
Role Employer/plan sponsor
Date 2021-03-15
Name of individual signing JESSICA FISH
PENN YAN MANOR NURSING HOME, INC. 401(K) PROFIT SHARING PLAN 2019 160967993 2020-03-06 PENN YAN MANOR NURSING HOME, INC. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 N. LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2020-03-06
Name of individual signing JESSICA FISH
Role Employer/plan sponsor
Date 2020-03-06
Name of individual signing JESSICA FISH
PENN YAN MANOR NURSING HOME, INC. 401(K) PROFIT SHARING PLAN 2018 160967993 2019-03-06 PENN YAN MANOR NURSING HOME, INC. 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 N. LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2019-03-06
Name of individual signing JESSICA FISH
Role Employer/plan sponsor
Date 2019-03-06
Name of individual signing JESSICA FISH
PENN YAN MANOR NURSING HOME, INC. 401(K) PROFIT SHARING PLAN 2017 160967993 2018-02-22 PENN YAN MANOR NURSING HOME, INC. 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 N. LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2018-02-22
Name of individual signing JESSICA FISH
Role Employer/plan sponsor
Date 2018-02-22
Name of individual signing JESSICA FISH
PENN YAN MANOR NURSING HOME, INC. 401(K) PROFIT SHARING PLAN 2016 160967993 2017-07-05 PENN YAN MANOR NURSING HOME, INC. 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 N. LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2017-07-05
Name of individual signing JESSICA FISH
Role Employer/plan sponsor
Date 2017-07-05
Name of individual signing JESSICA FISH
PENN YAN MANOR NURSING HOME, INC. PROFIT SHARING PLAN AND TRUST 2015 160967993 2016-06-24 PENN YAN MANOR NURSING HOME, INC. 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 NORTH LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2016-06-24
Name of individual signing COLIN MAHER
PENN YAN MANOR NURSING HOME, INC. PROFIT SHARING PLAN AND TRUST 2014 160967993 2015-09-08 PENN YAN MANOR NURSING HOME, INC. 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-01-01
Business code 623000
Sponsor’s telephone number 3155362311
Plan sponsor’s address 655 NORTH LIBERTY STREET, PENN YAN, NY, 14527

Signature of
Role Plan administrator
Date 2015-09-08
Name of individual signing COLIN MAHER

Agent

Name Role Address
PENN YAN MANOR NURSING HOME, INC. Agent 655 LIBERTY ST., PENN YAN, NY, 14527

Filings

Filing Number Date Filed Type Effective Date
C306327-2 2001-08-24 ASSUMED NAME CORP INITIAL FILING 2001-08-24
864550-3 1970-10-21 CERTIFICATE OF AMENDMENT 1970-10-21
818994-9 1970-03-04 CERTIFICATE OF AMENDMENT 1970-03-04
818995-6 1970-03-04 CERTIFICATE OF AMENDMENT 1970-03-04
756371-7 1969-05-13 CERTIFICATE OF INCORPORATION 1969-05-13

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 21 Dec 2024

Sources: New York Secretary of State

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