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  5. FORT ORANGE CLAIM SERVICE, INC.

FORT ORANGE CLAIM SERVICE, INC.

Headquarter

Company Details

Name: FORT ORANGE CLAIM SERVICE, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 15 May 1980 (45 years ago)
Entity Number: 627843
ZIP code: 12065
County: Saratoga
Place of Formation: New York
Address: 646 plank rd., suite 209, CLIFTON PARK, NY, United States, 12065
Principal Address: 646 Plank Road, CLIFTON PARK, NY, United States, 12065

Shares Details

Shares issued 400

Share Par Value 0

Type NO PAR VALUE

Links between entities

Type Company Name Company Number State
Headquarter of FORT ORANGE CLAIM SERVICE, INC., FLORIDA F21000000275 FLORIDA
Headquarter of FORT ORANGE CLAIM SERVICE, INC., CONNECTICUT 1340040 CONNECTICUT

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2023 141618193 2024-10-08 FORT ORANGE CLAIM SERVICE, INC. 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s address 635 PLANK ROAD, PO BOX 447, CLIFTON PARK, NY, 12065

Signature of
Role Plan administrator
Date 2024-10-08
Name of individual signing STEPHEN CIURCZAK
Valid signature Filed with authorized/valid electronic signature
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2022 141618193 2023-09-26 FORT ORANGE CLAIM SERVICE, INC. 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s address 635 PLANK ROAD, PO BOX 447, CLIFTON PARK, NY, 12065

Signature of
Role Plan administrator
Date 2023-09-26
Name of individual signing STEPHEN CIURCZAK
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2021 141618193 2022-09-20 FORT ORANGE CLAIM SERVICE, INC. 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s address 635 PLANK ROAD, PO BOX 447, CLIFTON PARK, NY, 12065

Signature of
Role Plan administrator
Date 2022-09-20
Name of individual signing STEPHEN CIURCZAK
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2020 141618193 2021-10-01 FORT ORANGE CLAIM SERVICE, INC. 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s address 635 PLANK ROAD, PO BOX 447, CLIFTON PARK, NY, 12065

Signature of
Role Plan administrator
Date 2021-10-01
Name of individual signing STEPHEN CIURCZAK
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2019 141618193 2020-10-27 FORT ORANGE CLAIM SERVICE, INC. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s address 635 PLANK ROAD, PO BOX 447, CLIFTON PARK, NY, 12065
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2018 141618193 2019-12-03 FORT ORANGE CLAIM SERVICE, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s address 635 PLANK ROAD, PO BOX 447, CLIFTON PARK, NY, 12065
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2017 141618193 2018-10-02 FORT ORANGE CLAIM SERVICE, INC. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s mailing address PO BOX 447, CLIFTON PARK, NY, 12065
Plan sponsor’s address 635 PLANK RD, CLIFTON PARK, NY, 12065

Number of participants as of the end of the plan year
Active participants 30
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 4
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 28
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2

Signature of
Role Plan administrator
Date 2018-10-02
Name of individual signing ALEXANDRIA VERSAILLES
Valid signature Filed with authorized/valid electronic signature
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2016 141618193 2017-10-05 FORT ORANGE CLAIM SERVICE, INC. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s mailing address PO BOX 447, CLIFTON PARK, NY, 12065
Plan sponsor’s address 635 PLANK RD, CLIFTON PARK, NY, 12065

Number of participants as of the end of the plan year
Active participants 27
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 4
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 28
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of
Role Plan administrator
Date 2017-10-05
Name of individual signing CYNTHIA HENDERER
Valid signature Filed with authorized/valid electronic signature
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2015 141618193 2016-07-28 FORT ORANGE CLAIM SERVICE, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s mailing address PO BOX 447, CLIFTON PARK, NY, 12065
Plan sponsor’s address 635 PLANK RD, CLIFTON PARK, NY, 12065

Number of participants as of the end of the plan year
Active participants 30
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 6
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 23
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 7

Signature of
Role Plan administrator
Date 2016-07-28
Name of individual signing CYNTHIA HENDERER
Valid signature Filed with authorized/valid electronic signature
FORT ORANGE CLAIM SERVICE, INC. 401(K) PLAN 2014 141618193 2015-08-18 FORT ORANGE CLAIM SERVICE, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 524290
Sponsor’s telephone number 5183832102
Plan sponsor’s mailing address PO BOX 447, CLIFTON PARK, NY, 12065
Plan sponsor’s address 635 PLANK RD, CLIFTON PARK, NY, 12065

Number of participants as of the end of the plan year
Active participants 19
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
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 18
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 2015-08-18
Name of individual signing CYNTHIA HENDERER
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 646 plank rd., suite 209, CLIFTON PARK, NY, United States, 12065

Chief Executive Officer

Name Role Address
STEPHEN G CIURCZAK Chief Executive Officer PO BOX 447, CLIFTON PARK, NY, United States, 12065

History

Start date End date Type Value
2024-05-17 2024-05-17 Address PO BOX 447, CLIFTON PARK, NY, 12065, USA (Type of address: Chief Executive Officer)
2024-05-17 2024-05-17 Shares Share type: NO PAR VALUE, Number of shares: 400, Par value: 0
2024-03-21 2024-05-17 Shares Share type: NO PAR VALUE, Number of shares: 400, Par value: 0
2023-09-15 2024-05-17 Address 646 plank rd., suite 209, CLIFTON PARK, NY, 12065, USA (Type of address: Service of Process)
2023-09-15 2023-09-15 Address PO BOX 447, CLIFTON PARK, NY, 12065, USA (Type of address: Chief Executive Officer)
2023-09-15 2024-05-17 Address PO BOX 447, CLIFTON PARK, NY, 12065, USA (Type of address: Chief Executive Officer)
2023-09-14 2024-03-21 Shares Share type: NO PAR VALUE, Number of shares: 400, Par value: 0
2022-07-06 2023-09-14 Shares Share type: NO PAR VALUE, Number of shares: 400, Par value: 0
2020-05-01 2023-09-15 Address 635 PLANK ROAD, PO BOX 447, CLIFTON PARK, NY, 12065, USA (Type of address: Service of Process)
2018-03-01 2020-05-01 Address P.O. BOX 447, CLIFTON PARK, NY, 12065, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240517003291 2024-05-17 BIENNIAL STATEMENT 2024-05-17
230915000195 2023-09-14 CERTIFICATE OF CHANGE BY ENTITY 2023-09-14
220503001029 2022-05-03 BIENNIAL STATEMENT 2022-05-01
200501060420 2020-05-01 BIENNIAL STATEMENT 2020-05-01
200207060438 2020-02-07 BIENNIAL STATEMENT 2018-05-01
180301000764 2018-03-01 CERTIFICATE OF CHANGE 2018-03-01
160511006519 2016-05-11 BIENNIAL STATEMENT 2016-05-01
150601007091 2015-06-01 BIENNIAL STATEMENT 2014-05-01
120703002537 2012-07-03 BIENNIAL STATEMENT 2012-05-01
100618002400 2010-06-18 BIENNIAL STATEMENT 2010-05-01

Related by officers

THE CORPORATION

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STEPHEN G CIURCZAK

FOCUS SOFTWARE, INC.

Related by address

No related companies by address

Date of last update: 21 Dec 2024

Sources: New York Secretary of State

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