| Name: | EDFORD L. CLARK, JR., DMD, PSC |
| Jurisdiction: | Kentucky |
| Profit or Non-Profit: | Profit |
| Legal type: | Kentucky Professional Services Corp |
| Status: | Inactive |
| Standing: | Bad |
| File Date: | 05 Oct 1987 (37 years ago) |
| Organization Date: | 05 Oct 1987 (37 years ago) |
| Last Annual Report: | 27 Sep 2022 (2 years ago) |
| Organization Number: | 0234817 |
| ZIP code: | 41653 |
| Primary County: | Floyd |
| Principal Office: | 415 N. LAKE DR., STE 201, PRESTONSBURG, KY 41653 |
| Place of Formation: | KENTUCKY |
| Authorized Shares: | 20 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EDFORD L CLARK JR DMD PSC CBS BENEFIT PLAN | 2022 | 611126342 | 2023-12-27 | EDFORD L CLARK JR DMD PSC | 2 | |||||||||||||||||||||||||||||||
|
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| 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 |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2021-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 6068864260 |
| Plan sponsor’s address | 415 N LAKE DRIVE, STE 201, PRESTONSBURG, KY, 41653 |
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 |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2021-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 6068864260 |
| Plan sponsor’s address | 415 N LAKE DRIVE, STE 201, PRESTONSBURG, KY, 41653 |
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 |
| Name | Role |
|---|---|
| EDFORD L. CLARK, JR. | Registered Agent |
| Name | Role |
|---|---|
| Edford L Clark, Jr | Sole Officer |
| Name | Role |
|---|---|
| Edford L Clark, Jr | Shareholder |
| Name | Role |
|---|---|
| EDFORD L. CLARK, JR. | Director |
| Edford L Clark, Jr | Director |
| Name | Role |
|---|---|
| EDFORD L. CLARK, JR. | Incorporator |
| Name | File Date |
|---|---|
| Administrative Dissolution | 2023-10-04 |
| Annual Report | 2022-09-27 |
| Annual Report | 2021-08-31 |
| Annual Report | 2020-08-10 |
| Annual Report | 2019-04-09 |
| Annual Report | 2018-03-29 |
| Annual Report | 2017-03-15 |
| Annual Report | 2016-03-18 |
| Annual Report | 2015-04-21 |
| Annual Report | 2014-03-21 |
Date of last update: 15 Dec 2024
Sources: Kentucky Secretary of State
