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  5. MCCLOUD CLAIMS SERVICE, INC.

MCCLOUD CLAIMS SERVICE, INC.

Company Details

Name: MCCLOUD CLAIMS SERVICE, INC.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 21 Sep 1983 (42 years ago)
Organization Date: 21 Sep 1983 (42 years ago)
Last Annual Report: 28 Jun 2024 (10 months ago)
Organization Number: 0181885
Industry: Insurance Agents, Brokers and Service
Number of Employees: Small (0-19)
ZIP code: 42104
City: Bowling Green
Primary County: Warren County
Principal Office: 1007 GRIDER POND RD, Bowling Green, KY 42104-4615
Place of Formation: KENTUCKY
Authorized Shares: 1000

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MCCLOUD CLAIMS SERVICE, INC. CBS BENEFIT PLAN 2022 611048879 2023-12-27 MCCLOUD CLAIMS SERVICE, INC. 4
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 524210
Sponsor’s telephone number 2707821515
Plan sponsor’s address 1190 BROADWAY AVE, BOWLING GREEN, KY, 42102

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
MCCLOUD CLAIMS SERVICE, INC. CBS BENEFIT PLAN 2021 611048879 2022-12-29 MCCLOUD CLAIMS SERVICE, INC. 4
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 524210
Sponsor’s telephone number 2707821515
Plan sponsor’s address 1190 BROADWAY AVE, BOWLING GREEN, KY, 42102

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
MCCLOUD CLAIMS SERVICE, INC. CBS BENEFIT PLAN 2020 611048879 2021-12-14 MCCLOUD CLAIMS SERVICE, INC. 4
Three-digit plan number (PN) 501
Effective date of plan 2021-01-01
Business code 524210
Sponsor’s telephone number 2707821515
Plan sponsor’s address 1190 BROADWAY AVE, BOWLING GREEN, KY, 42102

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
MCCLOUD CLAIMS SERVICE, INC. 401(K) PLAN 2011 611048879 2012-09-18 MCCLOUD CLAIMS SERVICE, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524290
Sponsor’s telephone number 2707821515
Plan sponsor’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102

Plan administrator’s name and address
Administrator’s EIN 611048879
Plan administrator’s name MCCLOUD CLAIMS SERVICE, INC.
Plan administrator’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102
Administrator’s telephone number 2707821515

Signature of
Role Plan administrator
Date 2012-09-18
Name of individual signing VICKI OLIVE
Valid signature Filed with authorized/valid electronic signature
MCCLOUD CLAIMS SERVICE, INC. 401(K) PLAN 2011 611048879 2012-07-26 MCCLOUD CLAIMS SERVICE, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524290
Sponsor’s telephone number 2707821515
Plan sponsor’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102

Plan administrator’s name and address
Administrator’s EIN 611048879
Plan administrator’s name MCCLOUD CLAIMS SERVICE, INC.
Plan administrator’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102
Administrator’s telephone number 2707821515

Signature of
Role Plan administrator
Date 2012-07-26
Name of individual signing VICKI OLIVE
Valid signature Filed with authorized/valid electronic signature
MCCLOUD CLAIMS SERVICE, INC. 401(K) PLAN 2010 611048879 2011-07-29 MCCLOUD CLAIMS SERVICE, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524290
Sponsor’s telephone number 2707821515
Plan sponsor’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102

Plan administrator’s name and address
Administrator’s EIN 611048879
Plan administrator’s name MCCLOUD CLAIMS SERVICE, INC.
Plan administrator’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102
Administrator’s telephone number 2707821515

Signature of
Role Plan administrator
Date 2011-07-29
Name of individual signing VICKI OLIVE
Valid signature Filed with authorized/valid electronic signature
MCCLOUD CLAIMS SERVICE, INC. 401(K) PLAN 2009 611048879 2010-09-29 MCCLOUD CLAIMS SERVICE, INC. 36
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524290
Sponsor’s telephone number 2707821515
Plan sponsor’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102

Plan administrator’s name and address
Administrator’s EIN 611048879
Plan administrator’s name MCCLOUD CLAIMS SERVICE, INC.
Plan administrator’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102
Administrator’s telephone number 2707821515

Signature of
Role Plan administrator
Date 2010-09-27
Name of individual signing VICKI OLIVE
Valid signature Filed with incorrect/unrecognized electronic signature
MCCLOUD CLAIMS SERVICE, INC. 401(K) PLAN 2009 611048879 2010-10-14 MCCLOUD CLAIMS SERVICE, INC. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524290
Sponsor’s telephone number 2707821515
Plan sponsor’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102

Plan administrator’s name and address
Administrator’s EIN 611048879
Plan administrator’s name MCCLOUD CLAIMS SERVICE, INC.
Plan administrator’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102
Administrator’s telephone number 2707821515

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing VICKI OLIVE
Valid signature Filed with authorized/valid electronic signature
MCCLOUD CLAIMS SERVICE, INC. 401(K) PLAN 2009 611048879 2010-10-14 MCCLOUD CLAIMS SERVICE, INC. 36
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 524290
Sponsor’s telephone number 2707821515
Plan sponsor’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102

Plan administrator’s name and address
Administrator’s EIN 611048879
Plan administrator’s name MCCLOUD CLAIMS SERVICE, INC.
Plan administrator’s address 1190 BROADWAY AVENUE, BOWLING GREEN, KY, 42102
Administrator’s telephone number 2707821515

Signature of
Role Plan administrator
Date 2010-09-27
Name of individual signing VICKI OLIVE
Valid signature Filed with incorrect/unrecognized electronic signature

Secretary

Name Role
Wanda J. McCloud Secretary

Officer

Name Role
Fred L. McCloud Officer

President

Name Role
Susan D. McCloud President

Vice President

Name Role
Russell L. McCloud Vice President

Director

Name Role
Fred L. McCloud Director
Wanda J. McCloud Director
FRED L. MCCLOUD Director
WANDA J. MCCLOUD Director

Incorporator

Name Role
FRED L. MCCLOUD Incorporator

Registered Agent

Name Role
FRED L. MCCLOUD Registered Agent

Licenses

Department License Number License Type / Line of Authority Status Issue Date Effective Date Inactive Date Expiry Date Address
Department of Insurance DOI ID 401260 Independent Adjuster - Property & Casualty Inactive 1994-03-04 - 2023-12-01 - -

Filings

Name File Date
Annual Report 2024-06-28
Principal Office Address Change 2024-06-28
Annual Report 2023-06-30
Annual Report 2022-06-21
Annual Report 2021-05-27
Annual Report 2020-06-26
Annual Report 2019-06-20
Annual Report 2018-06-28
Annual Report 2017-05-04
Annual Report 2016-04-06

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8129627708 2020-05-01 0457 PPP 1190 BROADWAY AVE, BOWLING GREEN, KY, 42104
Loan Status Date 2021-10-15
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 210647
Loan Approval Amount (current) 210647
Undisbursed Amount 0
Franchise Name -
Lender Location ID 53803
Servicing Lender Name U.S. Bank, National Association
Servicing Lender Address 425 Walnut St, CINCINNATI, OH, 45202-3956
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address BOWLING GREEN, WARREN, KY, 42104-0001
Project Congressional District KY-02
Number of Employees 15
NAICS code 524291
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 53803
Originating Lender Name U.S. Bank, National Association
Originating Lender Address CINCINNATI, OH
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 213560.95
Forgiveness Paid Date 2021-09-15
9156348703 2021-04-08 0457 PPS 1190 Broadway Ave, Bowling Green, KY, 42104-2444
Loan Status Date 2022-05-11
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 187500
Loan Approval Amount (current) 187500
Undisbursed Amount 0
Franchise Name -
Lender Location ID 124751
Servicing Lender Name American Bank & Trust Company, Inc.
Servicing Lender Address 1302 Scottsville, BOWLING GREEN, KY, 42102
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Bowling Green, WARREN, KY, 42104-2444
Project Congressional District KY-02
Number of Employees 13
NAICS code 541990
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 124751
Originating Lender Name American Bank & Trust Company, Inc.
Originating Lender Address BOWLING GREEN, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 189421.88
Forgiveness Paid Date 2022-04-21

Related by officers

FRED L. MCCLOUD

MCCLOUD OIL COMPANY

WANDA J. MCCLOUD

MCCLOUD OIL COMPANY

Related by address

No related companies by address

Sources: Kentucky Secretary of State

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