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KENTUCKY MINE SUPPLY COMPANY

Company Details

Name: KENTUCKY MINE SUPPLY COMPANY
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 19 Sep 1919 (106 years ago)
Organization Date: 19 Sep 1919 (106 years ago)
Last Annual Report: 09 Jul 2024 (9 months ago)
Organization Number: 0028196
Industry: General Merchandise Stores
Number of Employees: Small (0-19)
ZIP code: 40831
City: Harlan, Chevrolet, Smith
Primary County: Harlan County
Principal Office: P. O. BOX 779, HARLAN, KY 40831
Place of Formation: KENTUCKY
Authorized Shares: 2500

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KENTUCKY MINE SUPPLY CBS BENEFIT PLAN 2023 610246140 2024-12-30 KENTUCKY MINE SUPPLY 8
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 423800
Sponsor’s telephone number 6065733850
Plan sponsor’s address 213 RIVER ST, HARLAN, KY, 40831

Plan administrator’s name and address

Administrator’s EIN 846429706
Plan administrator’s name JOSEPH HSU
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of

Role Plan administrator
Date 2024-12-30
Name of individual signing JOSEPH HSU
Valid signature Filed with authorized/valid electronic signature
KENTUCKY MINE SUPPLY CBS BENEFIT PLAN 2022 610246140 2023-12-27 KENTUCKY MINE SUPPLY 11
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 423800
Sponsor’s telephone number 6065733850
Plan sponsor’s address 213 RIVER ST, HARLAN, KY, 40831

Plan administrator’s name and address

Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of

Role Plan administrator
Date 2023-12-27
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
KENTUCKY MINE SUPPLY CBS BENEFIT PLAN 2021 610246140 2022-12-29 KENTUCKY MINE SUPPLY 12
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 423800
Sponsor’s telephone number 6065733850
Plan sponsor’s address 213 RIVER ST, HARLAN, KY, 40831

Plan administrator’s name and address

Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of

Role Plan administrator
Date 2022-12-29
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
KENTUCKY MINE SUPPLY CBS BENEFIT PLAN 2020 610246140 2021-12-14 KENTUCKY MINE SUPPLY 12
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 423800
Sponsor’s telephone number 6065733850
Plan sponsor’s address 213 RIVER ST, HARLAN, KY, 40831

Plan administrator’s name and address

Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of

Role Plan administrator
Date 2021-12-14
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature

Secretary

Name Role
James B Bushnell Secretary

Vice President

Name Role
DeWayne L Williams Vice President

Director

Name Role
James M Bushnell Director
John G Myers Director
Timothy C. Howard Director
JAMES B. BUSHNELL Director
R. W. BAKER Director
C. A. BLACKBURN Director
P. T. COLGAN Director
J. J. MCCAMEY Director

Incorporator

Name Role
J. M. ROGAN Incorporator
JACK J. MCCAMEY Incorporator
P. T. COLGAN Incorporator
C. A. BLACKBURN Incorporator
H. A. MCCAMEY Incorporator

Registered Agent

Name Role
JAMES M. BUSHNELL Registered Agent

President

Name Role
James M Bushnell President

Filings

Name File Date
Annual Report 2024-07-09
Annual Report 2023-07-19
Annual Report 2022-08-17
Annual Report 2021-08-20
Annual Report 2020-06-29
Annual Report 2019-05-30
Annual Report 2018-05-09
Annual Report 2017-04-28
Annual Report 2016-04-05
Annual Report 2015-04-17

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5142798808 2021-04-17 0457 PPS 213 River St, Harlan, KY, 40831-2380
Loan Status Date 2021-10-06
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 146024
Loan Approval Amount (current) 146024
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27616
Servicing Lender Name Monticello Banking Company
Servicing Lender Address 50 N Main St, MONTICELLO, KY, 42633-2851
Rural or Urban Indicator R
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Harlan, HARLAN, KY, 40831-2380
Project Congressional District KY-05
Number of Employees 12
NAICS code 444190
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Cooperative
Originating Lender ID 27616
Originating Lender Name Monticello Banking Company
Originating Lender Address MONTICELLO, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 146560.09
Forgiveness Paid Date 2021-09-23

Sources: Kentucky Secretary of State