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  5. JOHN J. KACZOR FUNERAL HOME, INC.

JOHN J. KACZOR FUNERAL HOME, INC.

Company Details

Name: JOHN J. KACZOR FUNERAL HOME, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 28 Dec 1983 (41 years ago)
Entity Number: 883702
ZIP code: 14219
County: Erie
Place of Formation: New York
Address: 3450 SOUTH PARK AVENUE, BLASDELL, NY, United States, 14219

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOHN J KACZOR FUNERAL HOME INC 401(K) PROFIT SHARING PLAN TRUST 2023 161211253 2024-05-29 JOHN J KACZOR FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7169465654
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2024-05-29
Name of individual signing ANTHONY BASILE
JOHN J KACZOR FUNERAL HOME INC 401(K) PROFIT SHARING PLAN TRUST 2022 161211253 2023-05-28 JOHN J KACZOR FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7169465654
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2023-05-28
Name of individual signing ANTHONY BASILE
JOHN J KACZOR FUNERAL HOME INC 401(K) PROFIT SHARING PLAN TRUST 2021 161211253 2022-05-21 JOHN J KACZOR FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7169465654
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2022-05-21
Name of individual signing ANTHONY BASILE
JOHN J KACZOR FUNERAL HOME INC 401(K) PROFIT SHARING PLAN TRUST 2020 161211253 2021-06-24 JOHN J KACZOR FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7169465654
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2021-06-24
Name of individual signing ANTHONY BASILE
JOHN J KACZOR FUNERAL HOME INC 401(K) PROFIT SHARING PLAN & TRUST 2019 161211253 2020-05-07 JOHN J KACZOR FUNERAL HOME INC 11
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7165977700
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2020-05-07
Name of individual signing ANTHONY BASILE
JOHN J KACZOR FUNERAL HOME INC 401 K PROFIT SHARING PLAN TRUST 2018 161211253 2019-07-02 JOHN J KACZOR FUNERAL HOME INC 11
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7165977700
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2019-07-02
Name of individual signing JEFFREY HIRSHBERG
JOHN J KACZOR FUNERAL HOME INC 401 K PROFIT SHARING PLAN TRUST 2017 161211253 2018-07-19 JOHN J KACZOR FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7165977700
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2018-07-19
Name of individual signing JEFFREY HIRSHBERG CPA
JOHN J KACZOR FUNERAL HOME INC 401 K PROFIT SHARING PLAN TRUST 2016 161211253 2017-07-10 JOHN J KACZOR FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7165977700
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2017-07-10
Name of individual signing JEFFREY HIRSHBERG
JOHN J KACZOR FUNERAL HOME INC 401 K PROFIT SHARING PLAN TRUST 2015 161211253 2016-07-18 JOHN J KACZOR FUNERAL HOME INC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7165977700
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2016-07-18
Name of individual signing JEFFREY HIRSHBERG
JOHN J KACZOR FUNERAL HOME INC 401 K PROFIT SHARING PLAN TRUST 2014 161211253 2015-09-21 JOHN J KACZOR FUNERAL HOME INC 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1990-10-01
Business code 812210
Sponsor’s telephone number 7165977700
Plan sponsor’s address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219

Signature of
Role Plan administrator
Date 2015-09-21
Name of individual signing JEFFREY HIRSHBERG

Chief Executive Officer

Name Role Address
ANTHONY C. BASILE Chief Executive Officer 3450 SOUTH PARK AVENUE, BLASDELL, NY, United States, 14219

DOS Process Agent

Name Role Address
JOHN J. KACZOR FUNERAL HOME, INC. DOS Process Agent 3450 SOUTH PARK AVENUE, BLASDELL, NY, United States, 14219

History

Start date End date Type Value
2023-12-11 2023-12-11 Address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219, USA (Type of address: Chief Executive Officer)
2006-01-18 2023-12-11 Address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219, USA (Type of address: Service of Process)
2006-01-18 2023-12-11 Address 3450 SOUTH PARK AVENUE, BLASDELL, NY, 14219, USA (Type of address: Chief Executive Officer)
2001-11-27 2006-01-18 Address 3450 SOUTH PARK AVE, BLASDELL, NY, 14219, USA (Type of address: Chief Executive Officer)
2001-11-27 2006-01-18 Address 3450 SOUTH PARK AVE, BLASDELL, NY, 14219, USA (Type of address: Service of Process)
2001-11-27 2006-01-18 Address 3450 SOUTH PARK AVE, BLASDELL, NY, 14219, USA (Type of address: Principal Executive Office)
1997-12-08 2001-11-27 Address 3748 SOUTH PARK AVE, BLASDELL, NY, 14219, USA (Type of address: Chief Executive Officer)
1993-01-20 2001-11-27 Address 3748 SOUTH PARK AVE, BLASDELL, NY, 14219, USA (Type of address: Principal Executive Office)
1993-01-20 1997-12-08 Address 3748 SOUTH PARK AVE, BLASDELL, NY, 14219, USA (Type of address: Chief Executive Officer)
1993-01-20 2001-11-27 Address 3748 SOUTH PARK AVE, BLASDELL, NY, 14219, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
231211003844 2023-12-11 BIENNIAL STATEMENT 2023-12-01
140108002255 2014-01-08 BIENNIAL STATEMENT 2013-12-01
111227002095 2011-12-27 BIENNIAL STATEMENT 2011-12-01
091209002644 2009-12-09 BIENNIAL STATEMENT 2009-12-01
071206003061 2007-12-06 BIENNIAL STATEMENT 2007-12-01
060118002231 2006-01-18 BIENNIAL STATEMENT 2005-12-01
031208002582 2003-12-08 BIENNIAL STATEMENT 2003-12-01
011127002433 2001-11-27 BIENNIAL STATEMENT 2001-12-01
991224002007 1999-12-24 BIENNIAL STATEMENT 1999-12-01
971208002193 1997-12-08 BIENNIAL STATEMENT 1997-12-01

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5688038304 2021-01-25 0296 PPS 3450 S Park Ave, Blasdell, NY, 14219-1015
Loan Status Date 2021-10-20
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 63600
Loan Approval Amount (current) 63600
Undisbursed Amount 0
Franchise Name -
Lender Location ID 46027
Servicing Lender Name Evans Bank, National Association
Servicing Lender Address 8599 Erie Rd, ANGOLA, NY, 14006
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Blasdell, ERIE, NY, 14219-1015
Project Congressional District NY-23
Number of Employees 10
NAICS code 812210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 46027
Originating Lender Name Evans Bank, National Association
Originating Lender Address ANGOLA, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 63979.86
Forgiveness Paid Date 2021-09-02
2754807102 2020-04-11 0296 PPP 3450 S Park Ave, Blasdell, NY, 14219-1015
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) 63600
Loan Approval Amount (current) 63600
Undisbursed Amount 0
Franchise Name -
Lender Location ID 46027
Servicing Lender Name Evans Bank, National Association
Servicing Lender Address 8599 Erie Rd, ANGOLA, NY, 14006
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Blasdell, ERIE, NY, 14219-1015
Project Congressional District NY-23
Number of Employees 10
NAICS code 812210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 46027
Originating Lender Name Evans Bank, National Association
Originating Lender Address ANGOLA, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 64256.91
Forgiveness Paid Date 2021-05-03

Related by officers

No related officers

Related by address

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Date of last update: 17 Mar 2025

Sources: New York Secretary of State

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