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  5. SOUTH FORK ANIMAL HOSPITAL, PLLC

SOUTH FORK ANIMAL HOSPITAL, PLLC

Company Details

Name: SOUTH FORK ANIMAL HOSPITAL, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 27 Nov 2007 (17 years ago)
Entity Number: 3597987
ZIP code: 11975
County: Suffolk
Place of Formation: New York
Address: 340 MONTAUK HIGHWAY, PO BOX 1390, WAINSCOTT, NY, United States, 11975

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2023 261538305 2024-07-10 SOUTH FORK ANIMAL HOSPITAL 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2024-07-10
Name of individual signing MARK S. DAVIS
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2022 261538305 2023-07-19 SOUTH FORK ANIMAL HOSPITAL 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2023-07-19
Name of individual signing MARK S. DAVIS
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2021 261538305 2022-07-13 SOUTH FORK ANIMAL HOSPITAL 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2022-07-13
Name of individual signing MARK S. DAVIS
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2020 261538305 2021-07-28 SOUTH FORK ANIMAL HOSPITAL 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2021-07-28
Name of individual signing MARK S. DAVIS
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2019 261538305 2020-07-08 SOUTH FORK ANIMAL HOSPITAL 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2020-07-08
Name of individual signing MARK S. DAVIS
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2018 261538305 2019-07-22 SOUTH FORK ANIMAL HOSPITAL 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2019-07-22
Name of individual signing MARK S. DAVIS
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2017 261538305 2018-07-30 SOUTH FORK ANIMAL HOSPITAL 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2018-07-30
Name of individual signing MARK S. DAVIS
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2016 261538305 2017-07-27 SOUTH FORK ANIMAL HOSPITAL 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2017-07-27
Name of individual signing MARK S. DAVIS
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2015 261538305 2016-08-25 SOUTH FORK ANIMAL HOSPITAL 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2016-08-25
Name of individual signing MARK S. DAVIS
SOUTH FORK ANIMAL HOSPITAL 401K PROFIT SHARING PLAN 2014 261538305 2015-07-09 SOUTH FORK ANIMAL HOSPITAL 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621399
Sponsor’s telephone number 6315370035
Plan sponsor’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975

Plan administrator’s name and address
Administrator’s EIN 261538305
Plan administrator’s name SOUTH FORK ANIMAL HOSPITAL
Plan administrator’s address 340 MONTAUK HIGHWAY, WAINSCOTT, NY, 11975
Administrator’s telephone number 6315370035

Signature of
Role Plan administrator
Date 2015-07-09
Name of individual signing MARK S. DAVIS

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 340 MONTAUK HIGHWAY, PO BOX 1390, WAINSCOTT, NY, United States, 11975

History

Start date End date Type Value
2007-11-27 2009-11-20 Address 241 PANTIGO ROAD, EAST HAMPTON, NY, 11937, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
191114060344 2019-11-14 BIENNIAL STATEMENT 2019-11-01
171122006227 2017-11-22 BIENNIAL STATEMENT 2017-11-01
151105006583 2015-11-05 BIENNIAL STATEMENT 2015-11-01
131107007017 2013-11-07 BIENNIAL STATEMENT 2013-11-01
111213002290 2011-12-13 BIENNIAL STATEMENT 2011-11-01
091120002733 2009-11-20 BIENNIAL STATEMENT 2009-11-01
071127000956 2007-11-27 ARTICLES OF ORGANIZATION 2007-11-27

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3118787102 2020-04-11 0235 PPP 340 MONTAUK HWY, WAINSCOTT, NY, 11975-2000
Loan Status Date 2021-05-12
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 115220
Loan Approval Amount (current) 115220
Undisbursed Amount 0
Franchise Name -
Lender Location ID 46391
Servicing Lender Name Manufacturers and Traders Trust Company
Servicing Lender Address One M & T Plaza, 15th Fl, BUFFALO, NY, 14203
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address WAINSCOTT, SUFFOLK, NY, 11975-2000
Project Congressional District NY-01
Number of Employees 8
NAICS code 541940
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 15793
Originating Lender Name Manufacturers and Traders Trust Company
Originating Lender Address Bridgeport, CT
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 116353.26
Forgiveness Paid Date 2021-04-22

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State

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