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  5. EMPIRE BUSINESS FORMS, INC.

EMPIRE BUSINESS FORMS, INC.

Company Details

Name: EMPIRE BUSINESS FORMS, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Inactive
Date of registration: 21 Jun 1978 (47 years ago)
Date of dissolution: 05 Oct 2018
Entity Number: 496083
ZIP code: 12603
County: Dutchess
Place of Formation: New York
Address: PO BOX 3360, POUGHKEEPSIE, NY, United States, 12603
Principal Address: 265 LAKE SHORE DR, PLESANT VALLEY, NY, United States, 12569

Shares Details

Shares issued 20000

Share Par Value 0.01

Type PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPIRE BUSINESS FORMS INC 401 K PROFIT SHARING PLAN TRUST 2012 141602488 2013-09-10 EMPIRE BUSINESS FORMS INC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 424100
Sponsor’s telephone number 8455627780
Plan sponsor’s address 128 SOUTH ROBINSON AVENUE, NEWBURGH, NY, 12550

Signature of
Role Plan administrator
Date 2013-09-10
Name of individual signing EMPIRE BUSINESS FORMS INC
EMPIRE BUSINESS FORMS INC 401 K PROFIT SHARING PLAN TRUST 2012 141602488 2013-06-17 EMPIRE BUSINESS FORMS INC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 424100
Sponsor’s telephone number 8455627780
Plan sponsor’s address 128 SOUTH ROBINSON AVENUE, NEWBURGH, NY, 12550

Signature of
Role Plan administrator
Date 2013-06-17
Name of individual signing EMPIRE BUSINESS FORMS INC
EMPIRE BUSINESS FORMS INC. 401K PROFIT SHARING PLAN AND TRUST 2010 141602488 2010-12-17 EMPIRE BUSINESS FORMS, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 453210
Sponsor’s telephone number 8455627780
Plan sponsor’s mailing address 120 SOUTH ROBINSON AVENUE, NEWBURGH, NY, 12550
Plan sponsor’s address 120 SOUTH ROBINSON AVENUE, NEWBURGH, NY, 12550

Plan administrator’s name and address
Administrator’s EIN 141602488
Plan administrator’s name EMPIRE BUSINESS FORMS, INC.
Plan administrator’s address 120 SOUTH ROBINSON AVENUE, NEWBURGH, NY, 12550
Administrator’s telephone number 8455627780

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-12-17
Name of individual signing MICHAEL RICE
Valid signature Filed with authorized/valid electronic signature
EMPIRE BUSINESS FORMS INC. 401K PROFIT SHARING PLAN AND TRUST 2009 141602488 2010-10-15 EMPIRE BUSINESS FORMS, INC. 19
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 453210
Sponsor’s telephone number 8454715666
Plan sponsor’s mailing address P.O. BOX 3360, POUGHKEEPSIE, NY, 12603
Plan sponsor’s address P.O. BOX 3360, POUGHKEEPSIE, NY, 12603

Plan administrator’s name and address
Administrator’s EIN 141602488
Plan administrator’s name EMPIRE BUSINESS FORMS, INC.
Plan administrator’s address P.O. BOX 3360, POUGHKEEPSIE, NY, 12603
Administrator’s telephone number 8454715666

Number of participants as of the end of the plan year
Active participants 15
Number of participants with account balances as of the end of the plan year 11
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Employer/plan sponsor
Date 2010-10-15
Name of individual signing MICHAEL RICE
Valid signature Filed with authorized/valid electronic signature
EMPIRE BUSINESS FORMS INC. 401K PROFIT SHARING PLAN AND TRUST 2009 141602488 2010-10-15 EMPIRE BUSINESS FORMS, INC. 19
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 453210
Sponsor’s telephone number 8454715666
Plan sponsor’s mailing address P.O. BOX 3360, POUGHKEEPSIE, NY, 12603
Plan sponsor’s address P.O. BOX 3360, POUGHKEEPSIE, NY, 12603

Plan administrator’s name and address
Administrator’s EIN 141602488
Plan administrator’s name EMPIRE BUSINESS FORMS, INC.
Plan administrator’s address P.O. BOX 3360, POUGHKEEPSIE, NY, 12603
Administrator’s telephone number 8454715666

Number of participants as of the end of the plan year
Active participants 15
Number of participants with account balances as of the end of the plan year 11
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Employer/plan sponsor
Date 2010-10-15
Name of individual signing MICHAEL RICE
Valid signature Filed with authorized/valid electronic signature
EMPIRE BUSINESS FORMS INC. 401K PROFIT SHARING PLAN AND TRUST 2009 141602488 2010-10-15 EMPIRE BUSINESS FORMS, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 453210
Sponsor’s telephone number 8454715666
Plan sponsor’s mailing address P.O. BOX 3360, POUGHKEEPSIE, NY, 12603
Plan sponsor’s address P.O. BOX 3360, POUGHKEEPSIE, NY, 12603

Plan administrator’s name and address
Administrator’s EIN 141602488
Plan administrator’s name EMPIRE BUSINESS FORMS, INC.
Plan administrator’s address P.O. BOX 3360, POUGHKEEPSIE, NY, 12603
Administrator’s telephone number 8454715666

Number of participants as of the end of the plan year
Active participants 15
Number of participants with account balances as of the end of the plan year 11
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing MICHAEL RICE
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
MICHAEL RICE Chief Executive Officer PO BOX 3360, POUGHKEEPSIE, NY, United States, 12603

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent PO BOX 3360, POUGHKEEPSIE, NY, United States, 12603

History

Start date End date Type Value
2006-06-07 2010-07-01 Address 222 HURLEY RD, SALT POINT, NY, 12578, USA (Type of address: Principal Executive Office)
1995-07-18 2010-07-01 Address NONE, NONE, NONE, NY, 00000, USA (Type of address: Chief Executive Officer)
1995-07-18 2006-06-07 Address 305 HURLEY RD, SALT POINT, NY, 12578, USA (Type of address: Principal Executive Office)
1978-06-21 1995-07-18 Address 313 MILL ST., POUGHKEEPSIE, NY, 12601, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
181005000607 2018-10-05 CERTIFICATE OF DISSOLUTION 2018-10-05
140611006574 2014-06-11 BIENNIAL STATEMENT 2014-06-01
20140312008 2014-03-12 ASSUMED NAME CORP INITIAL FILING 2014-03-12
120713003027 2012-07-13 BIENNIAL STATEMENT 2012-06-01
100701002352 2010-07-01 BIENNIAL STATEMENT 2010-06-01
080624002980 2008-06-24 BIENNIAL STATEMENT 2008-06-01
060607003015 2006-06-07 BIENNIAL STATEMENT 2006-06-01
040708002345 2004-07-08 BIENNIAL STATEMENT 2004-06-01
020524002168 2002-05-24 BIENNIAL STATEMENT 2002-06-01
000602002186 2000-06-02 BIENNIAL STATEMENT 2000-06-01

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
339190639 0213100 2013-07-11 128 S. ROBINSON AVE. UNIT #2, NEWBURGH, NY, 12550
Inspection Type Complaint
Scope Partial
Safety/Health Safety
Close Conference 2013-07-11
Emphasis L: FORKLIFT
Case Closed 2013-07-11

Related Activity
Type Complaint
Activity Nr 827928
Safety Yes
338209018 0213100 2013-01-08 128 S. ROBINSON AVE. UNIT #2, NEWBURGH, NY, 12550
Inspection Type FollowUp
Scope Partial
Safety/Health Safety
Close Conference 2013-01-08
Case Closed 2013-01-25

Related Activity
Type Complaint
Activity Nr 354406
Safety Yes
Health Yes
Type Inspection
Activity Nr 432791
Safety Yes
334327913 0213100 2012-05-18 128 S. ROBINSON AVE. UNIT #2, NEWBURGH, NY, 12550
Inspection Type Complaint
Scope Complete
Safety/Health Safety
Close Conference 2012-05-22
Emphasis N: AMPUTATE
Case Closed 2013-01-25

Related Activity
Type Complaint
Activity Nr 354406
Safety Yes
Health Yes

Violation Items
Citation ID 01001A
Citaton Type Serious
Standard Cited 19100036 D01
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 1700.0
Initial Penalty 2800.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 4
Gravity 10
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.36(d)(1): Employees must be able to open an exit route door from the inside at all times without keys, tools, or special knowledge. A device such as a panic bar that locks only from the outside is permitted on exit discharge doors. a) Warehouse area- on and before 5/22/12- Rear exit door was secured closed exposing employees to an entrapment hazard in the event of a fire.
Citation ID 01001B
Citaton Type Serious
Standard Cited 19100036 E
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-11-19
Nr Instances 2
Nr Exposed 4
Gravity 10
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.36(e): A side-hinged exit door must be used. a) Warehouse area- On and before 05/22/12- Employees were exposed to an entrapment hazard due to the use of two garage roll up type doors labeled as exits.
Citation ID 01001C
Citaton Type Serious
Standard Cited 19100037 B02
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 4
Gravity 10
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.37(b)(2): Each exit was not clearly visible and marked by a sign reading "Exit": a) Printing area- On and before 5/18/12- Employees were exposed to a fire entrapment hazard due to the lack of an exit discharge sign.
Citation ID 01001D
Citaton Type Serious
Standard Cited 19100037 B04
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 4
Gravity 10
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.37(b)(4): Signs were not posted along the exit access indicating the direction of travel to the nearest exit and exit discharge when the direction of travel to the exit or exit discharge was not immediately apparent: a) Thoughout facility- On and before 5/22/12- Direction of travel signs were not in place to direct employees to the closest emergency exit area in the event of a fire.
Citation ID 01002
Citaton Type Serious
Standard Cited 19100106 E09 III
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 900.0
Initial Penalty 1600.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 4
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.106(e)(9)(iii): Combustible waste material and residues in a building or unit operating area were not kept to a minimum, stored in covered metal receptacles and disposed of daily: a) Printing press area- On or about 5/22/12- a fire hazard existed when rags saturated with combustible Red Magic X blanket cleaner and business form inks were not stored in a covered metal receptacle.
Citation ID 01003
Citaton Type Serious
Standard Cited 19100147 C01
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 1700.0
Initial Penalty 2800.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 8
Gravity 10
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.147(c)(1): The employer did not establish a program consisting of an energy control procedure, employee training and periodic inspections to ensure that before any employee performed any servicing or maintenance on a machine or equipment where the unexpected energing, startup or release of stored energy could occur and cause injury, the machine or equipment shall be isolated from the energy source and rendered inoperative: a) Throughout the facility- On and before 05/18/12- Employer failed to provide energy control procedures and training for affected and authorized employees performing maintenance on collating equipment, printers and paper cutters.
Citation ID 01004
Citaton Type Serious
Standard Cited 19100178 L
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 1100.0
Initial Penalty 2000.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 2
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.178(l): Operators were not trained in the safe operation of powered industrial trucks: a) Warehouse area- On and before 05/18/12- Employees operating a Clark LPG powered industrial truck were not trained in the safe operation of the vehicle.
Citation ID 01005
Citaton Type Serious
Standard Cited 19100212 A03 II
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 1600.0
Initial Penalty 2800.0
Final Order 2012-11-19
Nr Instances 4
Nr Exposed 2
Gravity 10
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.212(a)(3)(ii): Point(s) of operation of machinery were not guarded to prevent employee(s) from having any part of their body in the danger zone(s) during operating cycle(s): a) Printing and collating area- On or about 5/16/12- Shear head on the #1 Harris Schriber collator was not equipped with machine guarding exposing employees to an amputation hazard. b) Printing and collating area- On and before 5/18/12- Shear head on the #2 Harris Schriber collator was not equipped with machine guarding exposing employees to an amputation hazard. c) Printing and collating area- On or about 4/15/12- Shear head on the #3 Harris Schriber collator was not equipped with machine guarding exposing employees to an amputation hazard. d) Printing and collating area- On or about 5/17/12- Shear head on the #5 Harris Schriber collator was not equipped with machine guarding exposing employees to an amputation hazard.
Citation ID 01006A
Citaton Type Serious
Standard Cited 19100219 D01
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 1100.0
Initial Penalty 2000.0
Final Order 2012-11-19
Nr Instances 2
Nr Exposed 2
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.219(d)(1): Pulley(s) with part(s) seven feet or less from the floor or work platform were not guarded in accordance with the requirements specified in 29 CFR 1910.219(m) and (o): a) Collator area- On and before 05/22/12- Bostitich wire stitcher pulleys were not equipped with machine guarding exposing employees to an amputation hazard. b) Collator area- On and before 05/22/12- Bostitich wire stitcher pulleys were not equipped with machine guarding exposing employees to an amputation hazard.
Citation ID 01006B
Citaton Type Serious
Standard Cited 19100219 E03 I
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 1
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.219(e)(3)(i): Vertical or inclined belt(s) were not enclosed by guard(s) conforming to the requirements specified at 29 CFR 1910.219(m) and (o) a) Collator area- On and before 05/22/12- Bostitch wire stitcher belts were not equipped with machine guarding exposing employees to an amputation hazard. b) Collator area- On and before 05/22/12- #7 Bostitch wire stitcher belts were not equipped with machine guarding exposing employees to an amputation hazard.
Citation ID 01007A
Citaton Type Serious
Standard Cited 19100219 F01
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 1100.0
Initial Penalty 2000.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 1
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.219(f)(1): Gear(s) were not guarded by a complete enclosure or by one of the methods specified in 29 CFR 1910.219(f)(1)(ii) and (f)(1)(iii): a) Schriber snap collator- On and before 05/16/12- Gears on the Harris Schriber collator were not fully guarded and exposed employees to an in-running nip point hazard.
Citation ID 01007B
Citaton Type Serious
Standard Cited 19100219 F03
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 3
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.219(f)(1): Gear(s) were not guarded by a complete enclosure or by one of the methods specified in 29 CFR 1910.219(f)(1)(ii) and (f)(1)(iii): a) Harris Schriber collator 8 station- On and before 5/18/12- Collator drive chains and sprockets were not equipped with guarding exposing employees to in-running nip points.
Citation ID 01008
Citaton Type Serious
Standard Cited 19100242 B
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 900.0
Initial Penalty 1600.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 1
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.242(b): Compressed air used for cleaning purposes was not reduced to less than 30 p.s.i.: a) Offset press area- On and before 5/18/12- Shop air set at 80 psi was used for cleaning purposes exposing employees to eye injury hazards.
Citation ID 01009A
Citaton Type Serious
Standard Cited 19100303 F01
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 1100.0
Initial Penalty 2000.0
Final Order 2012-11-19
Nr Instances 2
Nr Exposed 3
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.303(f)(1): Each disconnecting means required by Subpart S of Part 1910 for motors and appliances was not legibly marked to indicate its purpose, nor located and arranged so the purpose was evident: a) Paper cutting area- On and before 5/18/12- The 220v electrical power motor disconnect for the Challenge paper cutter was not equipped with labeling. b) Collator area- On and before 5/18/12- The 220v electrical motor disconnect for the #1 Harris Schriber collator was not equipped with labeling.
Citation ID 01009B
Citaton Type Serious
Standard Cited 19100303 F02
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 2
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.303(f)(2): Each service, feeder, and branch circuit, at its disconnecting means or overcurrent device, was not legibly marked to indicate its purpose, nor located and arranged so the purpose was evident: a) Warehouse area- On and before 5/18/12- The electrical panel service box was not equipped with legible markings indicating the amperage of the electrical service and the purpose of overcurrent devices.
Citation ID 01010
Citaton Type Serious
Standard Cited 19100305 B01
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 900.0
Initial Penalty 1600.0
Final Order 2012-11-19
Nr Instances 2
Nr Exposed 4
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.305(b)(1): Unused openings in cabinets, boxes, and fittings were not effectively closed. a) Collator area- Harris Schriber collator #1- On and before 05/18/12- Knockout on the motor controller was not equipped with a cover. b) Collator area- Harris Schriber collator #1- Electrical junction box on the motor for the units roller system was not equipped with knockout covers.
Citation ID 01011
Citaton Type Serious
Standard Cited 19100334 A02 I
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 900.0
Initial Penalty 1600.0
Final Order 2012-11-19
Nr Instances 1
Nr Exposed 1
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.334(a)(2)(i): Portable cord and plug connected equipment and flexible cord sets (extension cords) were not visually inspected before use on any shift for external defects (such as loose parts, deformed and missing pins, or damage to outer jacket or insulation) and for evidence of possible internal damage (such as pinched or crushed outer jacket): a) Wire Stitcher area- On and before 05/18/12- Bostitch Wire Stitcher Model #7 sn# G778226 was missing its grounding pin exposing employees to an electrical shock hazard.
Citation ID 02001
Citaton Type Other
Standard Cited 19101200 H01
Issuance Date 2012-10-23
Abatement Due Date 2012-10-30
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2012-11-19
Nr Instances 2
Nr Exposed 4
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1200(h)(1): Employees were not provided effective information and training on hazardous chemicals in their work area at the time of their initial assignment and whenever a new hazard that the employees had not been previously trained about was introduced into their work area: a) Printing area- On and before 05/18/12- The employer did not provide employees information and training on hazardous chemicals in their work area, i.e. Prisco Red Magic X blanket wash and business form ink both of which are combustible products.

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No related companies by address

Date of last update: 18 Mar 2025

Sources: New York Secretary of State

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