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  5. CAREFIRST NY, INC.

CAREFIRST NY, INC.

Company Details

Name: CAREFIRST NY, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 31 Mar 1982 (43 years ago)
Entity Number: 761006
ZIP code: 14830
County: Chemung
Place of Formation: New York
Address: 11751 EAST CORNING ROAD, CORNING, NY, United States, 14830

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2023 222416679 2024-10-04 CAREFIRST NY, INC. 99
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2024-10-03
Name of individual signing CAITLIN WEST
Valid signature Filed with authorized/valid electronic signature
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2022 222416679 2023-10-17 CAREFIRST NY, INC. 92
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing DONAL K FORD
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2021 222416679 2022-09-27 CAREFIRST NY, INC. 85
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2022-09-25
Name of individual signing DONAL K FORD
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2020 222416679 2021-08-17 CAREFIRST NY, INC. 88
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2021-08-17
Name of individual signing DONAL K FORD
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2019 222416679 2020-10-05 CAREFIRST NY, INC. 82
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2020-10-05
Name of individual signing DONAL K FORD
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2015 222416679 2016-02-23 CAREFIRST NY, INC. 92
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Signature of
Role Plan administrator
Date 2016-02-23
Name of individual signing STACEY LEE
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2015 222416679 2016-12-13 CAREFIRST NY, INC. 82
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Signature of
Role Plan administrator
Date 2016-12-13
Name of individual signing STACEY LEE
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2014 222416679 2015-04-07 CAREFIRST NY, INC. 100
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 11751 E. CORNING ROAD, CORNING, NY, 14830

Signature of
Role Plan administrator
Date 2015-04-07
Name of individual signing STACEY LEE
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2013 222416679 2014-09-29 CAREFIRST NY, INC. 106
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 11751 E. CORNING ROAD, CORNING, NY, 14830

Signature of
Role Plan administrator
Date 2014-09-29
Name of individual signing STACEY LEE
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2012 222416679 2013-09-26 CAREFIRST NY, INC. 63
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 11751 E. CORNING ROAD, CORNING, NY, 14830

Signature of
Role Plan administrator
Date 2013-09-26
Name of individual signing STACEY LEE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 11751 EAST CORNING ROAD, CORNING, NY, United States, 14830

History

Start date End date Type Value
2002-06-07 2012-08-01 Name SOUTHERN TIER HOSPICE AND PALLIATIVE CARE
2002-06-07 2012-08-01 Address 11751 EAST CORNING ROAD, CORNING, NY, 14830, USA (Type of address: Service of Process)
1986-06-09 2002-06-07 Name SOUTHERN TIER HOSPICE CORPORATION
1982-03-31 1986-06-09 Name SOUTHERN TIER HOSPICARE CORPORATION
1982-03-31 2002-06-07 Address 175 GRAND CENTRAL AVE., ELMIRA HEIGHTS, NY, 14903, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
120801000297 2012-08-01 CERTIFICATE OF AMENDMENT 2012-08-01
020607000108 2002-06-07 CERTIFICATE OF AMENDMENT 2002-06-07
B367614-9 1986-06-09 CERTIFICATE OF AMENDMENT 1986-06-09
A855012-11 1982-03-31 CERTIFICATE OF INCORPORATION 1982-03-31

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
22-2416679 Corporation Unconditional Exemption 3805 MEADS CREEK RD, PAINTED POST, NY, 14870-9509 1987-06
In Care of Name % TALITHA SUTTON
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-12
Asset 5,000,000 to 9,999,999
Income 5,000,000 to 9,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 8799586
Income Amount 9933557
Form 990 Revenue Amount 6872705
National Taxonomy of Exempt Entities -
Sort Name DBA CAREFIRST

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name CAREFIRST NY INC
EIN 22-2416679
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name CAREFIRST NY INC
EIN 22-2416679
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name CAREFIRST NY INC
EIN 22-2416679
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name CAREFIRST NY INC
EIN 22-2416679
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name CAREFIRST NY INC
EIN 22-2416679
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name CAREFIRST NY INC
EIN 22-2416679
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name CAREFIRST NY INC
EIN 22-2416679
Tax Period 201612
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9438967202 2020-04-28 0248 PPP 3805 MEADS CREEK RD, PAINTED POST, NY, 14870-9509
Loan Status Date 2021-09-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 800000
Loan Approval Amount (current) 800000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 47180
Servicing Lender Name Chemung Canal Trust Company
Servicing Lender Address One Chemung Canal Plz, ELMIRA, NY, 14901-3408
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address PAINTED POST, STEUBEN, NY, 14870-9509
Project Congressional District NY-23
Number of Employees 70
NAICS code 621610
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 47180
Originating Lender Name Chemung Canal Trust Company
Originating Lender Address ELMIRA, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 810577.78
Forgiveness Paid Date 2021-08-25

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Related by address

11751 EAST CORNING ROAD, CORNING, NY, United States, 14830

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Date of last update: 28 Feb 2025

Sources: New York Secretary of State

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