THE CLEVELAND HOME
|
2023
|
610461733
|
2024-10-15
|
THE CLEVELAND HOME
|
29
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 403839571
|
Signature of
Role |
Plan administrator |
Date |
2024-10-15 |
Name of individual signing |
AARON WAINSCOTT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE CLEVELAND HOME CBS BENEFIT PLAN
|
2022
|
610461733
|
2023-12-27
|
THE CLEVELAND HOME
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2022-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 40383
|
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 |
2023-12-27 |
Name of individual signing |
SHAWNA BURTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN FOR EMPLOYEES OF THE CLEVELAND HOME
|
2022
|
610461733
|
2023-07-13
|
THE CLEVELAND HOME
|
23
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 403839571
|
Signature of
Role |
Plan administrator |
Date |
2023-07-13 |
Name of individual signing |
AARON WAINSCOTT |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE CLEVELAND HOME CBS BENEFIT PLAN
|
2021
|
610461733
|
2022-12-29
|
THE CLEVELAND HOME
|
8
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2022-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 40383
|
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 |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2021
|
610461733
|
2022-10-17
|
THE CLEVELAND HOME
|
26
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 403839571
|
Signature of
Role |
Plan administrator |
Date |
2022-10-17 |
Name of individual signing |
BEN HEIL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2020
|
610461733
|
2021-07-23
|
THE CLEVELAND HOME
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 403839571
|
Signature of
Role |
Plan administrator |
Date |
2021-07-23 |
Name of individual signing |
CATHERINE TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2019
|
610461733
|
2020-09-25
|
THE CLEVELAND HOME
|
27
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 403839571
|
Signature of
Role |
Plan administrator |
Date |
2020-09-25 |
Name of individual signing |
CATHERINE TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2018
|
610461733
|
2019-10-03
|
THE CLEVELAND HOME
|
34
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 403839571
|
Signature of
Role |
Plan administrator |
Date |
2019-10-03 |
Name of individual signing |
CATHERINE TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403 B THRIFT PLAN OF THE CLEVELAND HOME
|
2017
|
610461733
|
2018-07-16
|
THE CLEVELAND HOME
|
27
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 403839571
|
Signature of
Role |
Plan administrator |
Date |
2018-07-16 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-07-16 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2016
|
610461733
|
2017-07-25
|
THE CLEVELAND HOME
|
28
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2003-01-01
|
Business code |
624100
|
Sponsor’s telephone number |
8598733271
|
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 40383
|
Signature of
Role |
Plan administrator |
Date |
2017-07-25 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-25 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2015
|
610461733
|
2016-07-25
|
THE CLEVELAND HOME
|
29
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/25/20160725121651P030049098663001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
624100 |
Sponsor’s telephone number |
8598733271 |
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 40383 |
Signature of
Role |
Plan administrator |
Date |
2016-07-25 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-25 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2014
|
610461733
|
2015-07-30
|
THE CLEVELAND HOME
|
16
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/30/20150730091840P040046335117001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
624100 |
Sponsor’s telephone number |
8598733271 |
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 40383 |
Signature of
Role |
Plan administrator |
Date |
2015-07-30 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-30 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2013
|
610461733
|
2014-10-15
|
THE CLEVELAND HOME
|
17
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/15/20141015104959P040020238271001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
624100 |
Sponsor’s telephone number |
8598733271 |
Plan sponsor’s
address |
PO BOX 447, VERSAILLES, KY, 40383 |
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-10-15 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2012
|
610461733
|
2013-07-26
|
THE CLEVELAND HOME
|
24
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/26/20130726102427P040322358211001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
624100 |
Sponsor’s telephone number |
8598733271 |
Plan sponsor’s
address |
PO BOX 447, VERSAILLES, KY, 40383 |
Signature of
Role |
Plan administrator |
Date |
2013-07-26 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-07-26 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2011
|
610461733
|
2012-10-04
|
THE CLEVELAND HOME
|
21
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/04/20121004144632P030012706256001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
624100 |
Sponsor’s telephone number |
8598733271 |
Plan sponsor’s
address |
PO BOX 447, VERSAILLES, KY, 40383 |
Plan administrator’s name and address
Administrator’s EIN |
610461733 |
Plan administrator’s name |
THE CLEVELAND HOME |
Plan administrator’s
address |
PO BOX 447, VERSAILLES, KY, 40383 |
Administrator’s telephone number |
8598733271 |
Signature of
Role |
Plan administrator |
Date |
2012-10-04 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-10-04 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403B THRIFT PLAN OF THE CLEVELAND HOME
|
2010
|
610461733
|
2011-10-17
|
THE CLEVELAND HOME, INC.
|
21
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/17/20111017113511P040695603696001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
624100 |
Sponsor’s telephone number |
8598733271 |
Plan sponsor’s
address |
PO BOX 447, VERSAILLES, KY, 40383 |
Plan administrator’s name and address
Administrator’s EIN |
610461733 |
Plan administrator’s name |
THE CLEVELAND HOME, INC. |
Plan administrator’s
address |
PO BOX 447, VERSAILLES, KY, 40383 |
Administrator’s telephone number |
8598733271 |
Signature of
Role |
Plan administrator |
Date |
2011-10-17 |
Name of individual signing |
CATHY TERRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
403(B) THRIFT PLAN OF THE CLEVELAND HOME
|
2009
|
610461733
|
2010-10-05
|
THE CLEVELAND HOME
|
21
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/05/20101005091919P070010550657001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2003-01-01 |
Business code |
624100 |
Sponsor’s telephone number |
8598733271 |
Plan sponsor’s
address |
570 MILNER RD, VERSAILLES, KY, 40383 |
Plan administrator’s name and address
Administrator’s EIN |
610461733 |
Plan administrator’s name |
THE CLEVELAND HOME |
Plan administrator’s
address |
570 MILNER RD, VERSAILLES, KY, 40383 |
Administrator’s telephone number |
8598733271 |
Signature of
Role |
Plan administrator |
Date |
2010-10-05 |
Name of individual signing |
ROBERT HALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-10-05 |
Name of individual signing |
ROBERT HALL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|