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  5. FREDERICK & SMITH, INC.

FREDERICK & SMITH, INC.

Company Details

Name: FREDERICK & SMITH, INC.
Legal type: Kentucky Corporation
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 24 Sep 1985 (40 years ago)
Organization Date: 24 Sep 1985 (40 years ago)
Last Annual Report: 08 Jul 2024 (9 months ago)
Organization Number: 0206377
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 41472
City: West Liberty, Blairs Mill, Blaze, Caney, Cottle, Dingu...
Primary County: Morgan County
Principal Office: CLINIC PHARMACY, 412 LIBERTY RD., WEST LIBERTY, KY 41472
Place of Formation: KENTUCKY
Common No Par Shares: 2000

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2023 611083490 2024-06-17 FREDERICK & SMITH, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2022 611083490 2023-05-10 FREDERICK & SMITH, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2023-05-09
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2021 611083490 2022-09-07 FREDERICK & SMITH, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2022-09-07
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-07
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2020 611083490 2021-09-10 FREDERICK & SMITH, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2021-09-10
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2019 611083490 2020-09-11 FREDERICK & SMITH, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2020-09-11
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2018 611083490 2019-07-29 FREDERICK & SMITH, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2017 611083490 2018-10-08 FREDERICK & SMITH, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2018-10-08
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2016 611083490 2017-10-16 FREDERICK & SMITH, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2017-10-15
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2015 611083490 2016-10-14 FREDERICK & SMITH, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
FREDERICK & SMITH, INC. 401(K) PROFIT SHARING PLAN 2014 611083490 2015-10-13 FREDERICK & SMITH, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/14/20141014134002P030017418111001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2014-10-14
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/15/20131015083429P040007186871001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/15/20121015145433P030007501729001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Plan administrator’s name and address
Administrator’s EIN 611083490
Plan administrator’s name FREDERICK & SMITH, INC.
Plan administrator’s address P.O. BOX 277, WEST LIBERTY, KY, 41472
Administrator’s telephone number 6067434957

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/13/20111013085906P030148031201001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Plan administrator’s name and address
Administrator’s EIN 611083490
Plan administrator’s name FREDERICK & SMITH, INC.
Plan administrator’s address P.O. BOX 277, WEST LIBERTY, KY, 41472
Administrator’s telephone number 6067434957

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/11/20101011111300P030007484002001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 446110
Sponsor’s telephone number 6067434957
Plan sponsor’s address P.O. BOX 277, WEST LIBERTY, KY, 41472

Plan administrator’s name and address
Administrator’s EIN 611083490
Plan administrator’s name FREDERICK & SMITH, INC.
Plan administrator’s address P.O. BOX 277, WEST LIBERTY, KY, 41472
Administrator’s telephone number 6067434957

Signature of
Role Plan administrator
Date 2010-10-11
Name of individual signing JAMES FREDERICK
Valid signature Filed with authorized/valid electronic signature

Officer

Name Role
James Frederick Officer

Director

Name Role
LUTHER SMITH Director

Registered Agent

Name Role
DR. JAMES FREDERICK Registered Agent

Incorporator

Name Role
CHARLES E. CHRISTIAN Incorporator

Assumed Names

Name Status Expiration Date
CLINIC PHARMACY OF WEST LIBERTY Inactive 2020-03-25

Filings

Name File Date
Dissolution 2024-12-19
Annual Report 2024-07-08
Principal Office Address Change 2024-07-08
Annual Report 2023-03-16
Annual Report 2022-05-18
Certificate of Assumed Name 2022-02-22
Annual Report 2021-02-09
Annual Report 2020-03-02
Annual Report 2019-04-01
Annual Report 2018-04-17

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7154149009 2021-05-23 0457 PPS 3810 Leland Rd Apt 11, Louisville, KY, 40207-1953
Loan Status Date 2021-09-28
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 29137
Loan Approval Amount (current) 29137
Undisbursed Amount 0
Franchise Name -
Lender Location ID 509316
Servicing Lender Name Harvest Small Business Finance, LLC
Servicing Lender Address 24422 Avenida de la Carlota Suite 400, Laguna Hills, CA, 92653
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Louisville, JEFFERSON, KY, 40207-1953
Project Congressional District KY-03
Number of Employees 1
NAICS code 722320
Borrower Race Black or African American
Borrower Ethnicity Not Hispanic or Latino
Business Type Sole Proprietorship
Originating Lender ID 514546
Originating Lender Name BSD Capital, LLC dba Lendistry
Originating Lender Address Brea, CA
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 29207.25
Forgiveness Paid Date 2021-08-31
5423408400 2021-02-08 0457 PPP 3829 Leland Rd, Louisville, KY, 40207-1949
Loan Status Date 2021-09-24
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 20833.33
Loan Approval Amount (current) 20833.33
Undisbursed Amount 0
Franchise Name -
Lender Location ID 529471
Servicing Lender Name Itria Ventures LLC
Servicing Lender Address One Penn Plaza, Suite 4530, New York, NY, 10119
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Louisville, JEFFERSON, KY, 40207-1949
Project Congressional District KY-03
Number of Employees 1
NAICS code 722320
Borrower Race Black or African American
Borrower Ethnicity Not Hispanic or Latino
Business Type Sole Proprietorship
Originating Lender ID 529471
Originating Lender Name Itria Ventures LLC
Originating Lender Address New York, NY
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 20935.18
Forgiveness Paid Date 2021-09-01

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Sources: Kentucky Secretary of State

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