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BROOKLAWN BLUEGRASS, INC.

Company Details

Name: BROOKLAWN BLUEGRASS, INC.
Jurisdiction: Kentucky
Profit or Non-Profit: Non-profit
Legal type: Kentucky Corporation
Status: Inactive
Standing: Good
File Date: 15 May 1986 (39 years ago)
Organization Date: 15 May 1986 (39 years ago)
Last Annual Report: 01 Jul 1987 (38 years ago)
Organization Number: 0215137
ZIP code: 40218
Primary County: Jefferson
Principal Office: 2125 GOLDSMITH LN., LOUISVILLE, KY 40218
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TAX DEFERRED ANNUITY PLAN BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC. 2014 610444793 2015-07-29 BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC. 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-05-01
Business code 624200
Sponsor’s telephone number 5025150405
Plan sponsor’s address 3121 BROOKLAWN CAMPUS DRIVE, LOUISVILLE, KY, 40218

Signature of

Role Plan administrator
Date 2015-07-29
Name of individual signing MAMIE NELSON
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC. 2013 610444793 2014-07-30 BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-05-01
Business code 624200
Sponsor’s telephone number 5025150405
Plan sponsor’s address C/O USPIRITUS, INC., 3121 BROOKLAWN CAMPUS DRIVE, LOUISVILLE, KY, 40218

Signature of

Role Plan administrator
Date 2014-07-30
Name of individual signing MAMIE NELSON
Valid signature Filed with authorized/valid electronic signature
BROOKLAWN PREMIUM ONLY PLAN 2011 610471572 2013-02-26 BROOKLAWN, INCORPORATED 147
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1992-05-01
Business code 813000
Sponsor’s telephone number 5024515177
Plan sponsor’s mailing address 3121 BROOKLAWN CAMPUS DRIVE, LOUISVILLE, KY, 40218
Plan sponsor’s address 3121 BROOKLAWN CAMPUS DRIVE, LOUISVILLE, KY, 40218

Plan administrator’s name and address

Administrator’s EIN 610471572
Plan administrator’s name BROOKLAWN, INCORPORATED
Plan administrator’s address 3121 BROOKLAWN CAMPUS DRIVE, LOUISVILLE, KY, 40218
Administrator’s telephone number 5024515177

Number of participants as of the end of the plan year

Active participants 137

Signature of

Role Plan administrator
Date 2013-02-04
Name of individual signing MARY KATE POLING
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC 2011 610444793 2012-07-30 BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-05-01
Business code 624200
Sponsor’s telephone number 5022454171
Plan sponsor’s address 11103 PARK ROAD, LOUISVILLE, KY, 40223

Plan administrator’s name and address

Administrator’s EIN 610444793
Plan administrator’s name BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC
Plan administrator’s address 11103 PARK ROAD, LOUISVILLE, KY, 40223
Administrator’s telephone number 5022454171

Signature of

Role Plan administrator
Date 2012-07-30
Name of individual signing BRAD WILLIAMSON
Valid signature Filed with authorized/valid electronic signature
BROOKLAWN PREMIUM ONLY PLAN 2010 610471572 2011-11-22 BROOKLAWN, INCORPORATED 166
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1992-05-01
Business code 813000
Sponsor’s telephone number 5024515177
Plan sponsor’s mailing address 2125 GOLDSMITH LANE, LOUISVILLE, KY, 40218
Plan sponsor’s address 2125 GOLDSMITH LANE, LOUISVILLE, KY, 40218

Plan administrator’s name and address

Administrator’s EIN 610471572
Plan administrator’s name BROOKLAWN, INCORPORATED
Plan administrator’s address 2125 GOLDSMITH LANE, LOUISVILLE, KY, 40218
Administrator’s telephone number 5024515177

Number of participants as of the end of the plan year

Active participants 147

Signature of

Role Plan administrator
Date 2011-11-04
Name of individual signing MARY KATE POLING
Valid signature Filed with authorized/valid electronic signature
BROOKLAWN PREMIUM ONLY PLAN 2009 610471572 2011-12-20 BROOKLAWN, INCORPORATED 210
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1992-05-01
Business code 813000
Sponsor’s telephone number 5024515177
Plan sponsor’s mailing address 2125 GOLDSMITH LANE, LOUISVILLE, KY, 40218
Plan sponsor’s address 3121 BROOKLAWN CAMPUS DRIVE, LOUISVILLE, KY, 40218

Plan administrator’s name and address

Administrator’s EIN 610471572
Plan administrator’s name BROOKLAWN, INCORPORATED
Plan administrator’s address 2125 GOLDSMITH LANE, LOUISVILLE, KY, 40218
Administrator’s telephone number 5024515177

Number of participants as of the end of the plan year

Active participants 166

Signature of

Role Plan administrator
Date 2011-12-07
Name of individual signing MARY KATE POLING
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC. 2009 610044793 2010-10-14 BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC. 34
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1984-05-01
Business code 624200
Sponsor’s telephone number 5022454171
Plan sponsor’s address 11103 PARK ROAD, LOUISVILLE, KY, 40223

Plan administrator’s name and address

Administrator’s EIN 610044793
Plan administrator’s name BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC.
Plan administrator’s address 11103 PARK ROAD, LOUISVILLE, KY, 40223
Administrator’s telephone number 5022454171

Signature of

Role Plan administrator
Date 2010-10-14
Name of individual signing RUTH DUNBAR
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
DONALD A. BUCHHOLD Registered Agent

Director

Name Role
ELMER J. SCHMEID Director
JOHN A. BUGBEE Director
JOHN L. HARTSTERN, JR. Director
PEG HORRIGAN Director
SANDY METTS Director

Incorporator

Name Role
DONALD A. BUCHHOLD Incorporator

Former Company Names

Name Action
BROOKLAWN, INCORPORATED Old Name
BELLEWOOD PRESBYTERIAN HOME FOR CHILDREN, INC. Merger
BROOKLAWN TREATMENT CENTER, INC. Merger
BROOKLAWN BLUEGRASS, INC. Merger
"THE PROTESTANT ORPHANS' HOME OF LOUISVILLE KY. Old Name
PRESBYTERIAN HOME FOR CHILDREN Old Name
GERMAN PROTESTANT ORPHAN ASYLUM COMPANY Old Name
SYNODICAL PRESBYTERIAN ORPHANGE Old Name
LOUISVILLE PRESBYTERIAN ORPHANGE Old Name
LOUISVILLE PRESBYTERIAN ORPHANS' ASYLUM Old Name

Date of last update: 13 Dec 2024

Sources: Kentucky Secretary of State