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  5. EMPIRE MEDICAL SYSTEMS, LLC

EMPIRE MEDICAL SYSTEMS, LLC

Company Details

Name: EMPIRE MEDICAL SYSTEMS, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Inactive
Date of registration: 30 Mar 2012 (13 years ago)
Date of dissolution: 18 Mar 2024
Entity Number: 4224904
ZIP code: 14564
County: Ontario
Place of Formation: New York
Address: 7240 WINCANTON WAY, VICTOR, NY, United States, 14564

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2023 454531658 2024-03-27 EMPIRE MEDICAL SYSTEMS LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2024-03-27
Name of individual signing JASON GOTHAM
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2023 454531658 2024-07-11 EMPIRE MEDICAL SYSTEMS LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2024-07-11
Name of individual signing JASON GOTHAM
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2022 454531658 2023-05-30 EMPIRE MEDICAL SYSTEMS LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2023-05-30
Name of individual signing JASON GOTHAM
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2021 454531658 2022-04-21 EMPIRE MEDICAL SYSTEMS LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2022-04-21
Name of individual signing JASON GOTHAM
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2020 454531658 2021-09-07 EMPIRE MEDICAL SYSTEMS LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2021-09-07
Name of individual signing JASON GOTHAM
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2019 454531658 2020-09-29 EMPIRE MEDICAL SYSTEMS LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2020-09-29
Name of individual signing JASON GOTHAM
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2018 454531658 2019-10-14 EMPIRE MEDICAL SYSTEMS LLC 6
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing JASON GOTHAM
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2018 454531658 2020-09-29 EMPIRE MEDICAL SYSTEMS LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2020-09-29
Name of individual signing JASON GOTHAM
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2017 454531658 2018-03-16 EMPIRE MEDICAL SYSTEMS LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2018-03-16
Name of individual signing JASON GOTHAM
EMPIRE MEDICAL SYSTEMS LLC 401K PLAN 2016 454531658 2017-04-24 EMPIRE MEDICAL SYSTEMS LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 541990
Sponsor’s telephone number 5858808791
Plan sponsor’s address 7240 WINCANTON WAY, VICTOR, NY, 14564

Signature of
Role Plan administrator
Date 2017-04-24
Name of individual signing JASON GOTHAM

DOS Process Agent

Name Role Address
JASON GOTHAM DOS Process Agent 7240 WINCANTON WAY, VICTOR, NY, United States, 14564

History

Start date End date Type Value
2012-03-30 2024-03-28 Address 7240 WINCANTON WAY, VICTOR, NY, 14564, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240328001862 2024-03-18 CERTIFICATE OF DISSOLUTION-CANCELLATION 2024-03-18
220210002091 2022-02-10 BIENNIAL STATEMENT 2022-02-10
180309006293 2018-03-09 BIENNIAL STATEMENT 2018-03-01
160304006730 2016-03-04 BIENNIAL STATEMENT 2016-03-01
140507002129 2014-05-07 BIENNIAL STATEMENT 2014-03-01
121005001026 2012-10-05 CERTIFICATE OF PUBLICATION 2012-10-05
120330001044 2012-03-30 ARTICLES OF ORGANIZATION 2012-03-30

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7497258405 2021-02-12 0219 PPS 7240 Wincanton Way, Victor, NY, 14564-9643
Loan Status Date 2022-04-15
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 75000
Loan Approval Amount (current) 75000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 224780
Servicing Lender Name New York Business Development Corporation
Servicing Lender Address 50 Beaver Street, Albany, NY, 12207-1538
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Victor, ONTARIO, NY, 14564-9643
Project Congressional District NY-24
Number of Employees 5
NAICS code 423450
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 224780
Originating Lender Name New York Business Development Corporation
Originating Lender Address Albany, NY
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 75556.85
Forgiveness Paid Date 2021-11-16
2726437210 2020-04-16 0219 PPP 7240 Wincanton way, Victor, NY, 14564
Loan Status Date 2021-06-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 41200
Loan Approval Amount (current) 41200
Undisbursed Amount 0
Franchise Name -
Lender Location ID 434162
Servicing Lender Name Citizens Bank, National Association
Servicing Lender Address 1 Citizens Plaza, PROVIDENCE, RI, 02903-1344
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Victor, ONTARIO, NY, 14564-0001
Project Congressional District NY-24
Number of Employees 5
NAICS code 423450
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 434162
Originating Lender Name Citizens Bank, National Association
Originating Lender Address PROVIDENCE, RI
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 41632.32
Forgiveness Paid Date 2021-05-13

Related by officers

JASON GOTHAM

INNOVATIVE TECHNOLOGICAL CONCEPTS, LLC

Related by address

7240 WINCANTON WAY, VICTOR, NY, United States, 14564

INNOVATIVE TECHNOLOGICAL CONCEPTS, LLC

Date of last update: 26 Mar 2025

Sources: New York Secretary of State

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