| Entity Name: | NCR SELF-SERVICE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 04 Oct 2004 (21 years ago) |
| Date of dissolution: | 26 Sep 2014 (11 years ago) |
| Last Event: | REVOKED FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (11 years ago) |
| Document Number: | M04000004167 |
| FEI/EIN Number |
201589862
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 200 COLONIAL CENTER PARKWAY, LAKE MARY, FL, 32746, US |
| Mail Address: | C/O NCR CORPORATION, CORP TAXES, 3095 SATELLITE BLVD, DULUTH, GA, 30096, US |
| ZIP code: | 32746 |
| County: | Seminole |
| Place of Formation: | DELAWARE |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GALVANON, AN NCR COMPANY RETIREMENT PLAN | 2009 | 201589862 | 2010-12-29 | NCR SELF SERVICE LLC | 4 | |||||||||||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 201589862 |
| Plan administrator’s name | NCR SELF SERVICE LLC |
| Plan administrator’s address | 2500 MAITLAND CENTER PKWY, MAITLAND, FL, 327517224 |
| Administrator’s telephone number | 9374457916 |
Number of participants as of the end of the plan year
| Active participants | 5 |
| Number of participants with account balances as of the end of the plan year | 5 |
| 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 | 2010-12-29 |
| Name of individual signing | EILEEN ALLEN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2004-03-15 |
| Business code | 541511 |
| Sponsor’s telephone number | 9374457916 |
| Plan sponsor’s mailing address | 2500 MAITLAND CENTER PKWY, MAITLAND, FL, 327517224 |
| Plan sponsor’s address | 2500 MAITLAND CENTER PKWY, MAITLAND, FL, 327517224 |
Plan administrator’s name and address
| Administrator’s EIN | 201589862 |
| Plan administrator’s name | NCR SELF SERVICE LLC |
| Plan administrator’s address | 2500 MAITLAND CENTER PKWY, MAITLAND, FL, 327517224 |
| Administrator’s telephone number | 9374457916 |
Number of participants as of the end of the plan year
| Active participants | 5 |
| Number of participants with account balances as of the end of the plan year | 5 |
| 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 | 2010-08-27 |
| Name of individual signing | EILEEN ALLEN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | - |
| NCR CORPORATION | Managing Member | 3095 SATELLITE BLVD, DULUTH, GA, 30096 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOKED FOR ANNUAL REPORT | 2014-09-26 | - | - |
| CHANGE OF MAILING ADDRESS | 2010-04-20 | 200 COLONIAL CENTER PARKWAY, LAKE MARY, FL 32746 | - |
| NAME CHANGE AMENDMENT | 2005-12-13 | NCR SELF-SERVICE LLC | - |
| CHANGE OF PRINCIPAL ADDRESS | 2005-04-30 | 200 COLONIAL CENTER PARKWAY, LAKE MARY, FL 32746 | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J08000135310 | TERMINATED | 1000000072297 | 6823 1615 | 2008-02-15 | 2028-04-23 | $ 2,006.22 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE/CENTRAL COLLECTIONS UNIT, 1379 BLOUNTSTOWN HWY, TALLAHASSEE FL323042716 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-10 |
| ANNUAL REPORT | 2012-03-20 |
| ANNUAL REPORT | 2011-03-23 |
| ANNUAL REPORT | 2010-04-20 |
| ANNUAL REPORT | 2009-04-27 |
| ANNUAL REPORT | 2008-04-21 |
| ANNUAL REPORT | 2007-04-26 |
| ANNUAL REPORT | 2006-05-01 |
| Name Change | 2005-12-13 |
| ANNUAL REPORT | 2005-04-30 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
