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  5. AMY S. CARRICO, DMD, PLLC

AMY S. CARRICO, DMD, PLLC

Company Details

Name: AMY S. CARRICO, DMD, PLLC
Jurisdiction: Kentucky
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
File Date: 05 Apr 2005 (20 years ago)
Organization Date: 05 Apr 2005 (20 years ago)
Last Annual Report: 12 Mar 2024 (10 months ago)
Managed By: Managers
Organization Number: 0610241
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42303
Primary County: Daviess
Principal Office: 2811 NEW HARTFORD RD SUITE D, OWENSBORO, KY 42303
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AMY S. CARRICO DMD PLLC 401(K) PROFIT SHARING PLAN 2023 202821408 2024-07-25 AMY S. CARRICO DMD, PLLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 2811 NEW HARTFORD ROAD, SUITE D, OWENSBORO, KY, 42303

Signature of
Role Plan administrator
Date 2024-07-23
Name of individual signing AMY S. CARRICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-23
Name of individual signing AMY S. CARRICO
Valid signature Filed with authorized/valid electronic signature
AMY S. CARRICO DMD PLLC 401(K) PROFIT SHARING PLAN 2022 202821408 2023-07-21 AMY S. CARRICO DMD, PLLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 2811 NEW HARTFORD ROAD, SUITE D, OWENSBORO, KY, 42303

Signature of
Role Plan administrator
Date 2023-07-21
Name of individual signing AMY S. CARRICO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-21
Name of individual signing AMY S. CARRICO
Valid signature Filed with authorized/valid electronic signature
AMY S. CARRICO DMD PLLC 401(K) PROFIT SHARING PLAN 2021 202821408 2022-07-29 AMY S. CARRICO DMD, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 2811 NEW HARTFORD ROAD, SUITE D, OWENSBORO, KY, 42303

Signature of
Role Plan administrator
Date 2022-07-27
Name of individual signing AMY S. CARRICO
Valid signature Filed with authorized/valid electronic signature
AMY S. CARRICO DMD PLLC 401(K) P/S PLAN 2020 202821408 2021-09-15 AMY S. CARRICO DMD PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 2811 NEW HARTFORD RD STE D, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 202821408
Plan administrator’s name AMY S. CARRICO DMD PLLC
Plan administrator’s address 2811 NEW HARTFORD RD STE D, OWENSBORO, KY, 42303
Administrator’s telephone number 2709251155

Signature of
Role Plan administrator
Date 2021-09-15
Name of individual signing AMY CARRICO
Valid signature Filed with authorized/valid electronic signature
AMY S. CARRICO DMD PLLC 401(K) P/S PLAN 2019 202821408 2020-07-20 AMY S. CARRICO DMD PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 2811 NEW HARTFORD RD STE D, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 202821408
Plan administrator’s name AMY S. CARRICO DMD PLLC
Plan administrator’s address 2811 NEW HARTFORD RD STE D, OWENSBORO, KY, 42303
Administrator’s telephone number 2709251155

Signature of
Role Plan administrator
Date 2020-07-20
Name of individual signing AMY CARRICO
Valid signature Filed with authorized/valid electronic signature
AMY S. CARRICO DMD PLLC 401(K) P/S PLAN 2018 202821408 2019-09-20 AMY S. CARRICO DMD PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 2811 NEW HARTFORD RD STE D, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 202821408
Plan administrator’s name AMY S. CARRICO DMD PLLC
Plan administrator’s address 2811 NEW HARTFORD RD STE D, OWENSBORO, KY, 42303
Administrator’s telephone number 2709251155

Signature of
Role Plan administrator
Date 2019-09-20
Name of individual signing AMY CARRICO
Valid signature Filed with authorized/valid electronic signature
AMY S. CARRICO DMD PLLC 401(K) P/S PLAN 2017 202821408 2018-06-16 AMY S. CARRICO DMD PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 2811 NEW HARTFORD RD STE D, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 202821408
Plan administrator’s name AMY S. CARRICO DMD PLLC
Plan administrator’s address 2811 NEW HARTFORD RD STE D, OWENSBORO, KY, 42303
Administrator’s telephone number 2709251155

Signature of
Role Plan administrator
Date 2018-06-16
Name of individual signing AMY CARRICO
Valid signature Filed with authorized/valid electronic signature
AMY S. CARRICO DMD PLLC 401(K) P/S PLAN 2016 202821408 2017-06-28 AMY S. CARRICO DMD PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 2200 E PARRISH AVE STE 201C, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 202821408
Plan administrator’s name AMY S. CARRICO DMD PLLC
Plan administrator’s address 2200 E PARRISH AVE STE 201C, OWENSBORO, KY, 42303
Administrator’s telephone number 2709251155

Signature of
Role Plan administrator
Date 2017-06-28
Name of individual signing AMY CARRICO
Valid signature Filed with authorized/valid electronic signature
AMY S. CARRICO DMD PLLC 401(K) P/S PLAN 2015 202821408 2016-09-07 AMY S. CARRICO DMD PLLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 2200 E PARRISH AVE STE 201C, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 202821408
Plan administrator’s name AMY S. CARRICO DMD PLLC
Plan administrator’s address 2200 E PARRISH AVE STE 201C, OWENSBORO, KY, 42303
Administrator’s telephone number 2709251155

Signature of
Role Plan administrator
Date 2016-09-07
Name of individual signing AMY CARRICO
Valid signature Filed with authorized/valid electronic signature
AMY S. CARRICO DMD PLLC 401(K) P/S PLAN 2014 202821408 2015-07-22 AMY S. CARRICO DMD PLLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 1605 SCHERM ROAD, OWENSBORO, KY, 42301

Plan administrator’s name and address
Administrator’s EIN 202821408
Plan administrator’s name AMY S. CARRICO DMD PLLC
Plan administrator’s address 1605 SCHERM ROAD, OWENSBORO, KY, 42301
Administrator’s telephone number 2709251155

Signature of
Role Plan administrator
Date 2015-07-22
Name of individual signing AMY CARRICO
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/05/09/20140509104553P040383234033001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 1605 SCHERM ROAD, OWENSBORO, KY, 42301

Plan administrator’s name and address
Administrator’s EIN 202821408
Plan administrator’s name AMY S. CARRICO DMD PLLC
Plan administrator’s address 1605 SCHERM ROAD, OWENSBORO, KY, 42301
Administrator’s telephone number 2709251155

Signature of
Role Plan administrator
Date 2014-05-09
Name of individual signing AMY CARRICO
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/05/31/20130531081010P030305981377001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 2709251155
Plan sponsor’s address 1605 SCHERM ROAD, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 202821408
Plan administrator’s name AMY S. CARRICO DMD PLLC
Plan administrator’s address 1605 SCHERM ROAD, OWENSBORO, KY, 42303
Administrator’s telephone number 2709251155

Signature of
Role Plan administrator
Date 2013-05-31
Name of individual signing AMY CARRICO
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
AMY S. CARRICO, D.M.D. Registered Agent

Manager

Name Role
AMY CARRICO Manager

Organizer

Name Role
AMY S. CARRICO D.M.D. Organizer

Filings

Name File Date
Annual Report 2024-03-12
Annual Report 2023-03-16
Annual Report 2022-03-06
Annual Report 2021-02-10
Annual Report 2020-03-25
Annual Report 2019-05-30
Annual Report 2018-05-11
Registered Agent name/address change 2017-06-09
Principal Office Address Change 2017-06-09
Annual Report 2017-06-09

Related by officers

AMY CARRICO

COMMUNITY CHRISTIAN ACADEMY, INC.

Related by address

No related companies by address

Date of last update: 05 Jan 2025

Sources: Kentucky Secretary of State

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