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  5. BLACKBURN & WARD FUNERAL HOME, INC.

BLACKBURN & WARD FUNERAL HOME, INC.

Company Details

Name: BLACKBURN & WARD FUNERAL HOME, INC.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 26 Jun 1995 (30 years ago)
Organization Date: 26 Jun 1995 (30 years ago)
Last Annual Report: 10 Jun 2024 (10 months ago)
Organization Number: 0402203
Industry: Miscellaneous Services
Number of Employees: Small (0-19)
ZIP code: 40383
City: Versailles
Primary County: Woodford County
Principal Office: 161 BROADWAY, VERSAILLES, KY 40383
Place of Formation: KENTUCKY
Authorized Shares: 1000

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLACKBURN & WARD FUNERAL HOME, INC., 401(K) PROFIT SHARING PLAN 2023 611283721 2024-04-18 BLACKBURN & WARD FUNERAL HOME, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2024-04-18
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-04-18
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
BLACKBURN & WARD FUNERAL HOME, INC., 401(K) PROFIT SHARING PLAN 2022 611283721 2023-03-31 BLACKBURN & WARD FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2023-03-31
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-03-31
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
BLACKBURN & WARD FUNERAL HOME, INC., 401(K) PROFIT SHARING PLAN 2021 611283721 2022-04-11 BLACKBURN & WARD FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2022-04-11
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-04-11
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
BLACKBURN & WARD FUNERAL HOME, INC., 401(K) PROFIT SHARING PLAN 2020 611283721 2021-04-07 BLACKBURN & WARD FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2021-04-07
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-07
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
BLACKBURN & WARD FUNERAL HOME, INC., 401(K) PROFIT SHARING PLAN 2019 611283721 2020-06-02 BLACKBURN & WARD FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2020-06-02
Name of individual signing WILLIAM BUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-02
Name of individual signing WILLIAM BUTCHER
Valid signature Filed with authorized/valid electronic signature
BLACKBURN & WARD FUNERAL HOME, INC., 401(K) PROFIT SHARING PLAN 2018 611283721 2019-07-03 BLACKBURN & WARD FUNERAL HOME, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2019-07-03
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-03
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
BLACKBURN & WARD FH, INC., 401(K) PSP 2016 611283721 2017-10-10 BLACKBURN & WARD FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2017-10-10
Name of individual signing BILLY BUTCHER
Valid signature Filed with authorized/valid electronic signature
BLACKBURN & WARD FH, INC., I-PSP 2015 611283721 2016-10-10 BLACKBURN & WARD FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing J STEPHEN WARD
Valid signature Filed with authorized/valid electronic signature
BLACKBURN & WARD FH, INC., I-401K PSP 2014 611283721 2015-04-03 BLACKBURN & WARD FUNERAL HOME, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2015-04-03
Name of individual signing J STEPHEN WARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-03
Name of individual signing J STEPHEN WARD
Valid signature Filed with authorized/valid electronic signature
BLACKBURN & WARD FH, INC., I-401K PSP 2013 611283721 2014-03-03 BLACKBURN & WARD FUNERAL HOME, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2014-03-03
Name of individual signing J STEPHEN WARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-03-03
Name of individual signing J STEPHEN WARD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/22/20130722090819P040400167169001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 40383

Signature of
Role Plan administrator
Date 2013-07-22
Name of individual signing J STEPHEN WARD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/11/20120711152512P040002711344001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 403831156

Plan administrator’s name and address
Administrator’s EIN 611283721
Plan administrator’s name BLACKBURN & WARD FUNERAL HOME, INC.
Plan administrator’s address 161 BROADWAY, VERSAILLES, KY, 403831156
Administrator’s telephone number 8598734991

Signature of
Role Plan administrator
Date 2012-07-11
Name of individual signing J STEPHEN WARD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/08/20110708081801P040092311169001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 403831156

Plan administrator’s name and address
Administrator’s EIN 611283721
Plan administrator’s name BLACKBURN & WARD FUNERAL HOME, INC.
Plan administrator’s address 161 BROADWAY, VERSAILLES, KY, 403831156
Administrator’s telephone number 8598734991

Signature of
Role Plan administrator
Date 2011-07-08
Name of individual signing J STEPHEN WARD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/06/30/20100630184754P030075794056001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 812210
Sponsor’s telephone number 8598734991
Plan sponsor’s address 161 BROADWAY, VERSAILLES, KY, 403831156

Plan administrator’s name and address
Administrator’s EIN 611283721
Plan administrator’s name BLACKBURN & WARD FUNERAL HOME, INC.
Plan administrator’s address 161 BROADWAY, VERSAILLES, KY, 403831156
Administrator’s telephone number 8598734991

Signature of
Role Plan administrator
Date 2010-06-30
Name of individual signing J STEPHEN WARD
Valid signature Filed with authorized/valid electronic signature

President

Name Role
William B. Butcher President

Treasurer

Name Role
William B. Butcher Treasurer

Registered Agent

Name Role
WILLIAM B. BUTCHER Registered Agent

Secretary

Name Role
Leigh Ann Lewis Secretary

Incorporator

Name Role
JAMES STEPHEN WARD Incorporator

Licenses

Department License Number License Type / Line of Authority Status Issue Date Effective Date Inactive Date Expiry Date Address
Department of Insurance DOI ID 398957 Agent - Life Pending Replacement 2017-02-16 - - 2025-03-31 -

Assumed Names

Name Status Expiration Date
KENTUCKY MEMORIALS CREMATORY Active 2030-02-05
KY MEMORIALS Active 2030-02-05
OLDHAM, ROBERTS & POWELL FUNERAL HOME Active 2029-12-16
TUCKER, YOCUM & WILSON FUNERAL HOME Active 2026-12-08
FOREVER MEMORIALS Expiring 2025-08-10

Filings

Name File Date
Certificate of Assumed Name 2025-02-05
Certificate of Assumed Name 2025-02-05
Certificate of Assumed Name 2024-12-13
Annual Report 2024-06-10
Annual Report 2023-05-02
Annual Report 2022-03-06
Certificate of Assumed Name 2021-12-08
Annual Report 2021-04-14
Certificate of Assumed Name 2020-08-10
Annual Report 2020-06-15

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8155947202 2020-04-28 0457 PPP 161 BROADWAY ST, VERSAILLES, KY, 40383-1156
Loan Status Date 2021-03-02
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 40953.2
Loan Approval Amount (current) 40953.2
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27217
Servicing Lender Name Independence Bank of Kentucky
Servicing Lender Address 2425 Frederica St, OWENSBORO, KY, 42301-5437
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address VERSAILLES, WOODFORD, KY, 40383-1156
Project Congressional District KY-06
Number of Employees 5
NAICS code 812210
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 27217
Originating Lender Name Independence Bank of Kentucky
Originating Lender Address OWENSBORO, KY
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 41251.65
Forgiveness Paid Date 2021-01-25

Related by officers

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Sources: Kentucky Secretary of State

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