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  5. CHAMPION ADJUSTMENT CO. LLC

CHAMPION ADJUSTMENT CO. LLC

Company Details

Name: CHAMPION ADJUSTMENT CO. LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 29 Aug 2005 (20 years ago)
Entity Number: 3249594
ZIP code: 11753
County: Queens
Place of Formation: New York
Address: 420 JERICHO TURNPIKE, SUITE 102, JERICHO, NY, United States, 11753

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2023 203400348 2024-09-25 CHAMPION ADJUSTMENT CO., LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TPKE. SUITE 222, JERICHO, NY, 11753
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2022 203400348 2023-10-02 CHAMPION ADJUSTMENT CO., LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TPKE. SUITE 222, JERICHO, NY, 11753

Signature of
Role Plan administrator
Date 2023-10-02
Name of individual signing GLEN ROSENBLOOM
Role Employer/plan sponsor
Date 2023-10-02
Name of individual signing GLEN ROSENBLOOM
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2021 203400348 2022-09-29 CHAMPION ADJUSTMENT CO., LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TPKE. SUITE 222, JERICHO, NY, 11753

Signature of
Role Plan administrator
Date 2022-09-29
Name of individual signing GLEN ROSENBLOOM
Role Employer/plan sponsor
Date 2022-09-29
Name of individual signing GLEN ROSENBLOOM
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2020 203400348 2021-08-04 CHAMPION ADJUSTMENT CO., LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TURNPIKE, SUITE 222, JERICHO, NY, 11753

Signature of
Role Plan administrator
Date 2021-08-04
Name of individual signing GLEN ROSENBLOOM
Role Employer/plan sponsor
Date 2021-08-04
Name of individual signing GLEN ROSENBLOOM
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2019 203400348 2020-09-15 CHAMPION ADJUSTMENT CO., LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TPKE. SUITE 222, JERICHO, NY, 11753

Signature of
Role Plan administrator
Date 2020-09-15
Name of individual signing GLEN ROSENBLOOM
Role Employer/plan sponsor
Date 2020-09-15
Name of individual signing GLEN ROSENBLOOM
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2018 203400348 2019-07-26 CHAMPION ADJUSTMENT CO., LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TPKE. SUITE 222, JERICHO, NY, 11753

Signature of
Role Plan administrator
Date 2019-07-25
Name of individual signing GLEN ROSENBLOOM
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2017 203400348 2018-10-08 CHAMPION ADJUSTMENT CO., LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TPKE. SUITE 102, JERICHO, NY, 11753

Signature of
Role Plan administrator
Date 2018-10-05
Name of individual signing GLEN ROSENBLOOM
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2016 203400348 2017-04-18 CHAMPION ADJUSTMENT CO., LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TPKE. SUITE 102, JERICHO, NY, 11753

Signature of
Role Plan administrator
Date 2017-04-17
Name of individual signing GLEN ROSENBLOOM
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2015 203400348 2016-07-11 CHAMPION ADJUSTMENT CO., LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TPKE. SUITE 102, JERICHO, NY, 11753

Signature of
Role Plan administrator
Date 2016-07-11
Name of individual signing GLEN ROSENBLOOM
Role Employer/plan sponsor
Date 2016-07-11
Name of individual signing GLEN ROSENBLOOM
CHAMPION ADJUSTMENT CO., LLC 401(K) PLAN 2014 203400348 2015-07-14 CHAMPION ADJUSTMENT CO., LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524290
Sponsor’s telephone number 5169352800
Plan sponsor’s address 420 JERICHO TPKE. SUITE 102, JERICHO, NY, 11753

Signature of
Role Plan administrator
Date 2015-07-14
Name of individual signing GLEN ROSENBLOOM

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 420 JERICHO TURNPIKE, SUITE 102, JERICHO, NY, United States, 11753

Agent

Name Role Address
JAMES SAWYER, ESQ. Agent 390 NORTH BROADWAY, SUITE 200, NEW YORK, NY, 11753

History

Start date End date Type Value
2014-06-17 2023-08-25 Address 390 NORTH BROADWAY, SUITE 200, NEW YORK, NY, 11753, USA (Type of address: Registered Agent)
2014-06-17 2023-08-25 Address 420 JERICHO TURNPIKE, SUITE 102, JERICHO, NY, 11753, USA (Type of address: Service of Process)
2005-08-29 2014-06-17 Address 25-77 FRANCIS LEWIS BLVD, BAYSIDE, NY, 11358, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
230825000324 2023-08-25 BIENNIAL STATEMENT 2023-08-01
210802000484 2021-08-02 BIENNIAL STATEMENT 2021-08-02
190802060838 2019-08-02 BIENNIAL STATEMENT 2019-08-01
170802006394 2017-08-02 BIENNIAL STATEMENT 2017-08-01
160122002045 2016-01-22 BIENNIAL STATEMENT 2015-08-01
140617000290 2014-06-17 CERTIFICATE OF CHANGE 2014-06-17
050829000940 2005-08-29 ARTICLES OF ORGANIZATION 2005-08-29

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8006848101 2020-07-24 0235 PPP 420 JERICHO TURNPIKE SUITE 222, JERICHO, NY, 11753-1319
Loan Status Date 2021-09-28
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 18400
Loan Approval Amount (current) 18400
Undisbursed Amount 0
Franchise Name -
Lender Location ID 123499
Servicing Lender Name BayFirst National Bank
Servicing Lender Address 700 Central Avenue, Saint Petersburg, FL, 33701
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Unanswered
Project Address JERICHO, NASSAU, NY, 11753-1319
Project Congressional District NY-03
Number of Employees 4
NAICS code 524298
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 123499
Originating Lender Name BayFirst National Bank
Originating Lender Address Saint Petersburg, FL
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 18592.07
Forgiveness Paid Date 2021-08-17
4140758308 2021-01-23 0235 PPS 420 Jericho Tpke Ste 222, Jericho, NY, 11753-1319
Loan Status Date 2022-11-23
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 15400
Loan Approval Amount (current) 15400
Undisbursed Amount 0
Franchise Name -
Lender Location ID 188567
Servicing Lender Name Loan Source Incorporated
Servicing Lender Address 353 East 83rd Street Suite 3H, NEW YORK, NY, 10028
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Jericho, NASSAU, NY, 11753-1319
Project Congressional District NY-03
Number of Employees 4
NAICS code 524298
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 123499
Originating Lender Name BayFirst National Bank
Originating Lender Address Saint Petersburg, FL
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 15649.78
Forgiveness Paid Date 2022-09-28

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Related by address

420 JERICHO TURNPIKE, SUITE 102, JERICHO, NY, United States, 11753

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State

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