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  5. GRAYSON COUNTY MEDICAL FOUNDATION, INC.

GRAYSON COUNTY MEDICAL FOUNDATION, INC.

Company Details

Name: GRAYSON COUNTY MEDICAL FOUNDATION, INC.
Legal type: Kentucky Corporation
Status: Inactive
Standing: Bad
Profit or Non-Profit: Non-profit
File Date: 12 Oct 1994 (31 years ago)
Organization Date: 12 Oct 1994 (31 years ago)
Last Annual Report: 07 Mar 2022 (3 years ago)
Organization Number: 0337047
ZIP code: 42754
City: Leitchfield
Primary County: Grayson County
Principal Office: 130 EAST MARKET STREET, LEITCHFIELD, KY 42754
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TWIN LAKES MEDICAL FOUNDATION, INC. 403(B) PLAN 2018 611269278 2019-02-07 TWIN LAKES MEDICAL FOUNDATION, INC. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-01-01
Business code 621399
Sponsor’s telephone number 2702591619
Plan sponsor’s address 908 WALLACE AVENUE, LEITCHFIELD, KY, 42754

Signature of
Role Plan administrator
Date 2019-02-07
Name of individual signing JOHN MERIWETHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-02-07
Name of individual signing JOHN MERIWETHER
Valid signature Filed with authorized/valid electronic signature
TWIN LAKES MEDICAL FOUNDATION, INC. 403(B) PLAN 2017 611269278 2018-09-24 TWIN LAKES MEDICAL FOUNDATION, INC. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-01-01
Business code 621399
Sponsor’s telephone number 0000000000
Plan sponsor’s address 908 WALLACE AVENUE, LEITCHFIELD, KY, 42754

Signature of
Role Plan administrator
Date 2018-09-24
Name of individual signing WAYNE MERIWETHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-24
Name of individual signing WAYNE MERIWETHER
Valid signature Filed with authorized/valid electronic signature
TWIN LAKES MEDICAL FOUNDATION, INC. 403(B) PLAN 2017 611269278 2018-09-24 TWIN LAKES MEDICAL FOUNDATION, INC. 2
Three-digit plan number (PN) 002
Effective date of plan 1995-01-01
Business code 621399
Sponsor’s telephone number 0000000000
Plan sponsor’s address 908 WALLACE AVENUE, LEITCHFIELD, KY, 42754

Signature of
Role Plan administrator
Date 2018-09-24
Name of individual signing WAYNE MERIWETHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-24
Name of individual signing WAYNE MERIWETHER
Valid signature Filed with authorized/valid electronic signature
TWIN LAKES MEDICAL FOUNDATION, INC. 403(B) PLAN 2016 611269278 2017-07-19 TWIN LAKES MEDICAL FOUNDATION, INC. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-01-01
Business code 621399
Sponsor’s telephone number 0000000000
Plan sponsor’s address 908 WALLACE AVENUE, LEITCHFIELD, KY, 42754

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing JOHN MERIWETHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-19
Name of individual signing JOHN MERIWETHER
Valid signature Filed with authorized/valid electronic signature
TWIN LAKES MEDICAL FOUNDATION, INC. 403(B) PLAN 2015 611269278 2016-07-14 TWIN LAKES MEDICAL FOUNDATION, INC. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-01-01
Business code 621399
Sponsor’s telephone number 0000000000
Plan sponsor’s address 908 WALLACE AVENUE, LEITCHFIELD, KY, 42754

Signature of
Role Plan administrator
Date 2016-07-14
Name of individual signing JOHN MERIWETHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-14
Name of individual signing JOHN MERIWETHER
Valid signature Filed with authorized/valid electronic signature
TWIN LAKES MEDICAL FOUNDATION, INC. 403(B) PLAN 2014 611269278 2015-05-14 TWIN LAKES MEDICAL FOUNDATION, INC. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1995-01-01
Business code 621399
Sponsor’s telephone number 0000000000
Plan sponsor’s address 908 WALLACE AVENUE, LEITCHFIELD, KY, 42754

Signature of
Role Plan administrator
Date 2015-05-14
Name of individual signing JOHN MERIWETHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-05-14
Name of individual signing JOHN MERIWETHER
Valid signature Filed with authorized/valid electronic signature

Director

Name Role
David Downs Director
Marla Cantway Director
Kenneth Green Director
PAUL BRYANT Director
CAROLYNTHOMASON Director
ANNA RAYE MONTGOMERY Director
Trevor Ray Director
Edwin McKinney Director

Incorporator

Name Role
STEPHEN L. MEREDITH Incorporator

Registered Agent

Name Role
WAYNE MERIWETHER Registered Agent

President

Name Role
Trevor Ray President

Secretary

Name Role
Edwin McKinney Secretary

Treasurer

Name Role
Edwin McKinney Treasurer

Vice President

Name Role
David Downs Vice President

Former Company Names

Name Action
TWIN LAKES MEDICAL FOUNDATION, INC. Old Name

Filings

Name File Date
Administrative Dissolution 2023-10-04
Annual Report 2022-03-07
Principal Office Address Change 2021-06-14
Annual Report 2021-06-14
Amendment 2020-12-07
Annual Report 2020-02-12
Annual Report 2019-04-19
Annual Report 2018-04-19
Annual Report 2017-04-26
Annual Report 2016-03-14

Related by officers

David Downs

GRAYSON COUNTY HOSPITAL FOUNDATION, INC. GRAYCO, INCORPORATED WTK HOLDINGS, INC. CUSTOM SERVICES, INC. SOUTH CARROLLTON MISSIONARY BAPTIST CHURCH, INC. Grayson County Healthcare Foundation, Inc.

Marla Cantway

GRAYSON COUNTY COMMUNITY HEALTH FOUNDATION, INC.

PAUL BRYANT

GRAYCO, INCORPORATED OTIS BRYANT AND SON, INC. PARKLAND MANOR, INC. BELL COUNTY ECONOMIC DEVELOPMENT FOUNDATION, INC. OK DEVELOPMENT COMPANY MOCA, INC. BRYANT SERVICES, LLC BRYANT FARMS, INC. PAUL B'S MEAT SHOP & DELI, INC OCS-NCS JV II LLC

STEPHEN L. MEREDITH

TRIUNITY HEALTH PLAN, INC. GRAYSON COUNTY COMMUNITY HEALTH FOUNDATION, INC.

WAYNE MERIWETHER

GRAYSON COUNTY HOSPITAL FOUNDATION, INC. GRAYCO, INCORPORATED GRAYSON COUNTY PUBLIC HOSPITAL DISTRICT CORPORATION TRI-COUNTY MEDICAL COLLECTIONS, INC. GRAYSON COUNTY COMMUNITY HEALTH FOUNDATION, INC.

Trevor Ray

GRAYSON COUNTY HOSPITAL FOUNDATION, INC. GRAYCO, INCORPORATED MEDICAL ARTS PHARMACY OF GLASGOW, INC. WTK HOLDINGS, INC. SUNNY POINT GENERAL BAPTIST CHURCH, INC. Ray's Hometown Market Inc GAAR, LLC Grayson County Healthcare Foundation, Inc.

Edwin McKinney

GRAYSON COUNTY HOSPITAL FOUNDATION, INC. GRAYCO, INCORPORATED FIRST BAPTIST CHURCH, LEITCHFIELD, KENTUCKY, INC. WTK HOLDINGS, INC. Grayson County Healthcare Foundation, Inc.

Related by address

130 EAST MARKET STREET, LEITCHFIELD, KY 42754

WTK HOLDINGS, INC.

Sources: Kentucky Secretary of State

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