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CASA OF SOUTH CENTRAL KENTUCKY, INC.

Company Details

Name: CASA OF SOUTH CENTRAL KENTUCKY, INC.
Jurisdiction: Kentucky
Profit or Non-Profit: Non-profit
Legal type: Kentucky Corporation
Status: Active
Standing: Good
File Date: 30 Sep 1998 (26 years ago)
Organization Date: 30 Sep 1998 (26 years ago)
Last Annual Report: 21 Mar 2024 (10 months ago)
Organization Number: 0462838
Industry: Social Services
Number of Employees: Small (0-19)
ZIP code: 42101
Primary County: Warren
Principal Office: 316 EAST TENTH AVE., P O BOX 867, BOWLING GREEN, KY 42101
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CASA OF SOUTH CENTRAL KENTUCKY, INC. CBS BENEFIT PLAN 2021 611334266 2022-12-29 CASA OF SOUTH CENTRAL KENTUCKY, INC. 1
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 813000
Sponsor’s telephone number 2707825353
Plan sponsor’s address 316 EAST 10TH AVENUE, BOWLING GREEN, KY, 42101

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
CASA OF SOUTH CENTRAL KENTUCKY, INC. CBS BENEFIT PLAN 2020 611334266 2021-12-14 CASA OF SOUTH CENTRAL KENTUCKY, INC. 1
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 813000
Sponsor’s telephone number 2707825353
Plan sponsor’s address 316 EAST 10TH AVENUE, BOWLING GREEN, KY, 42101

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
CASA OF SOUTH CENTRAL KENTUCKY, INC. CBS BENEFIT PLAN 2019 611334266 2020-12-23 CASA OF SOUTH CENTRAL KENTUCKY, INC. 1
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 813000
Sponsor’s telephone number 2707825353
Plan sponsor’s address 316 EAST 10TH AVENUE, BOWLING GREEN, KY, 42101

Plan administrator’s name and address

Administrator’s EIN 846429706
Plan administrator’s name KELLY WOLF
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of

Role Plan administrator
Date 2020-12-23
Name of individual signing KELLY WOLF
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
Melinda Hill Registered Agent

Vice President

Name Role
Jeff Peake Vice President

Treasurer

Name Role
Jessica Gifford Treasurer

Secretary

Name Role
Makayla Wood Secretary

Director

Name Role
Jason Heflin Director
Jerry Cousin Director
Aquesha Daniels Director
Jackie DeJaynes Director
Debbie Diamond Director
Ed Jent Director
Amanda Manship Director
Sharla Siemens Director
Mitchell Walker Director
Erin Warfel Director

President

Name Role
Michael Delaney President

Incorporator

Name Role
KATHY YURCHISIN Incorporator
CATHERINE RICE GAITHER Incorporator

Former Company Names

Name Action
CASA OF WARREN COUNTY, INC. Old Name

Assumed Names

Name Status Expiration Date
BARREN/METCALFE COUNTIES CASA Inactive 2008-09-17

Filings

Name File Date
Annual Report 2024-03-21
Annual Report 2023-03-30
Registered Agent name/address change 2023-03-30
Annual Report 2022-06-14
Annual Report 2021-06-07
Annual Report 2020-06-02
Annual Report 2019-06-10
Annual Report 2018-06-25
Annual Report 2017-06-27
Registered Agent name/address change 2016-06-22

Date of last update: 10 Jan 2025

Sources: Kentucky Secretary of State