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JEWISH HOME FOR THE AGED, INC.

Company Details

Entity Name: JEWISH HOME FOR THE AGED, INC.
Jurisdiction: Connecticut
Legal type: Non-Stock
Citizenship: Domestic
Status: Forfeited
Date Formed: 27 Jul 1915
Business ALEI: 0056289
Mailing address: 169 DAVENPORT AVE, NEW HAVEN, CT, 06519
Place of Formation: CONNECTICUT

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JEWISH HOME FOR THE AGED 401K PLAN 2010 060646693 2011-06-22 JEWISH HOME FOR THE AGED, INC. 101
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-04-01
Business code 623000
Sponsor’s telephone number 2037891650
Plan sponsor’s address 169 DAVENPORT AVE, NEW HAVEN, CT, 065191319

Plan administrator’s name and address

Administrator’s EIN 060646693
Plan administrator’s name JEWISH HOME FOR THE AGED, INC.
Plan administrator’s address 169 DAVENPORT AVE, NEW HAVEN, CT, 065191319
Administrator’s telephone number 2037891650

Signature of

Role Plan administrator
Date 2011-06-22
Name of individual signing BETH GOLDSTEIN
Valid signature Filed with authorized/valid electronic signature
JEWISH HOME FOR THE AGED 403B PLAN 2010 060646693 2011-07-19 JEWISH HOME FOR THE AGED, INC. 101
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 2037891650
Plan sponsor’s address 169 DAVENPORT AVE, NEW HAVEN, CT, 065191319

Plan administrator’s name and address

Administrator’s EIN 060646693
Plan administrator’s name JEWISH HOME FOR THE AGED, INC.
Plan administrator’s address 169 DAVENPORT AVE, NEW HAVEN, CT, 065191319
Administrator’s telephone number 2037891650

Signature of

Role Plan administrator
Date 2011-07-19
Name of individual signing BETH GOLDSTEIN
Valid signature Filed with authorized/valid electronic signature
JEWISH HOME FOR THE AGED 403B PLAN 2009 060646693 2010-07-20 JEWISH HOME FOR THE AGED, INC. 95
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 623000
Sponsor’s telephone number 2037891650
Plan sponsor’s address 169 DAVENPORT AVE, NEW HAVEN, CT, 065191319

Plan administrator’s name and address

Administrator’s EIN 060646693
Plan administrator’s name JEWISH HOME FOR THE AGED, INC.
Plan administrator’s address 169 DAVENPORT AVE, NEW HAVEN, CT, 065191319
Administrator’s telephone number 2037891650

Signature of

Role Plan administrator
Date 2010-07-20
Name of individual signing BETH GOLDSTEIN
Valid signature Filed with authorized/valid electronic signature
JEWISH HOME FOR THE AGED 401K PLAN 2009 060646693 2010-07-20 JEWISH HOME FOR THE AGED, INC. 68
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-04-01
Business code 623000
Sponsor’s telephone number 2037891650
Plan sponsor’s address 169 DAVENPORT AVE, NEW HAVEN, CT, 065191319

Plan administrator’s name and address

Administrator’s EIN 060646693
Plan administrator’s name JEWISH HOME FOR THE AGED, INC.
Plan administrator’s address 169 DAVENPORT AVE, NEW HAVEN, CT, 065191319
Administrator’s telephone number 2037891650

Signature of

Role Plan administrator
Date 2010-07-20
Name of individual signing BETH GOLDSTEIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Residence address
BRYAN MESH Agent 169 DAVENPORT AVE, NEW HAVEN, CT, 06519, United States 53 SCHOOLSIDE LANE, GUILFORD, CT, 06437, United States

Officer

Name Role Business address Residence address
ESTELLE HORWITZ Officer No data 9 ROBIN LANE, NEW HAVEN, CT, 06525, United States
BETH GOLDSTEIN Officer 169 DAVENPORT AVENUE, NEW HAVEN, CT, 06519, United States 169 BUTTERNUT LANE, STAMFORD, CT, United States
JAY KOSSMAN Officer 175 N MAIN ST, BRANFORD, CT, 06405, United States 26 TURTLE BAY DRIVE, BRANFORD, CT, 06405, United States
ZELLY GOLDBERG Officer 445 BOSTON POST ROAD, ORANGE, CT, 06471, United States 42 VISTA TERRACE, NEW HAVEN, CT, 06515, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CCNH.000032C Chronic & Convalescent Nursing Home INACTIVE INACTIVE 2009-04-01 2011-04-01 2013-03-31

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0010963257 2022-08-10 No data Administrative Dissolution Certificate of Dissolution/Revocation No data
BF-0010589709 2022-05-12 No data Administrative Dissolution Notice of Intent to Dissolve/Revoke No data
0004285135 2010-10-12 No data Annual Report Annual Report 2010
0004040452 2009-10-29 No data Annual Report Annual Report 2009
0004040420 2009-10-29 No data Annual Report Annual Report 2008
0003542267 2007-09-25 No data Annual Report Annual Report 2005
0003542269 2007-09-25 No data Annual Report Annual Report 2006
0003542265 2007-09-25 No data Annual Report Annual Report 2004
0003542275 2007-09-25 No data Annual Report Annual Report 2007
0003542260 2007-09-25 No data Annual Report Annual Report 2003

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website