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AFFINITY HOSPICE MANAGEMENT LLC

Company Details

Name: AFFINITY HOSPICE MANAGEMENT LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 10 Dec 2014 (10 years ago)
Entity Number: 4678207
ZIP code: 11210
County: Kings
Place of Formation: New York
Address: 2407 Avenue J, Brooklyn, NY, United States, 11210

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AFFINITY HOSPICE MANAGEMENT LLC 401(K) PLAN 2022 472507505 2023-10-03 AFFINITY HOSPICE MANAGEMENT LLC 113
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Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621610
Sponsor’s telephone number 6465852175
Plan sponsor’s address 2302 QUENTIN ROAD, BROOKLYN, NY, 11229

Signature of

Role Plan administrator
Date 2023-10-03
Name of individual signing CHRIS HORNE
AFFINITY HOSPICE MANAGEMENT LLC 401(K) PLAN 2021 472507505 2022-09-26 AFFINITY HOSPICE MANAGEMENT LLC 79
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621610
Sponsor’s telephone number 6465852175
Plan sponsor’s address 2302 QUENTIN ROAD, BROOKLYN, NY, 11229

Signature of

Role Plan administrator
Date 2022-09-26
Name of individual signing CHRIS HORNE
AFFINITY HOSPICE MANAGEMENT LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 472507505 2022-02-15 AFFINITY HOSPICE MANAGEMENT LLC 189
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621610
Sponsor’s telephone number 6465852175
Plan sponsor’s mailing address 2302 QUENTIN RD, BROOKLYN, NY, 112292414
Plan sponsor’s address 2302 QUENTIN RD, BROOKLYN, NY, 112292414

Number of participants as of the end of the plan year

Active participants 67
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 12
Number of participants with account balances as of the end of the plan year 48
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 10

Signature of

Role Plan administrator
Date 2022-02-15
Name of individual signing ARIEL JOUDAI
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
AFFINITY HOSPICE MANAGEMENT LLC DOS Process Agent 2407 Avenue J, Brooklyn, NY, United States, 11210

History

Start date End date Type Value
2024-11-04 2024-12-02 Address 2407 Avenue J, Brooklyn, NY, 11210, USA (Type of address: Service of Process)
2020-12-01 2024-11-04 Address 975 EAST 24TH ST, BROOKLYN, NY, 11210, USA (Type of address: Service of Process)
2017-09-26 2020-12-01 Address 850 EAST 24TH ST, BROOKLYN, NY, 11210, USA (Type of address: Service of Process)
2014-12-10 2017-09-26 Address PO BOX 10873, ALBANY, NY, 12201, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
241202006975 2024-12-02 BIENNIAL STATEMENT 2024-12-02
241104004828 2024-11-04 BIENNIAL STATEMENT 2024-11-04
201201061741 2020-12-01 BIENNIAL STATEMENT 2020-12-01
171026000041 2017-10-26 CERTIFICATE OF CHANGE 2017-10-26
170926000199 2017-09-26 CERTIFICATE OF CHANGE 2017-09-26
150224000103 2015-02-24 CERTIFICATE OF PUBLICATION 2015-02-24
141210010174 2014-12-10 ARTICLES OF ORGANIZATION 2014-12-10

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1872827409 2020-05-05 0202 PPP 975 E 24th Street, BROOKLYN, NY, 11210
Loan Status Date 2021-07-22
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 41777.54
Loan Approval Amount (current) 41777
Undisbursed Amount 0
Franchise Name -
Lender Location ID 48270
Servicing Lender Name JPMorgan Chase Bank, National Association
Servicing Lender Address 1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address BROOKLYN, KINGS, NY, 11210-0001
Project Congressional District NY-09
Number of Employees 2
NAICS code 621610
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 194093
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address CHICAGO, IL
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 42222.81
Forgiveness Paid Date 2021-06-03

Date of last update: 25 Mar 2025

Sources: New York Secretary of State