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Bluegrass Independent Case Management, LLC

Company Details

Name: Bluegrass Independent Case Management, LLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Deleted
Standing: Bad
File Date: 18 Oct 2011 (13 years ago)
Organization Date: 18 Oct 2011 (13 years ago)
Managed By: Members
Organization Number: 0803596
ZIP code: 41179
Primary County: Lewis
Principal Office: 142 Moore Holw, Vanceburg, KY 41179
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLUEGRASS INDEPENDENT CASE MANAGEMENT 401(K) P/S PLAN 2017 453566446 2018-09-17 BLUEGRASS INDEPENDENT CASE MANAGEMENT 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-10-06
Business code 624100
Sponsor’s telephone number 2704386672
Plan sponsor’s address 1725 ASHLEY CIR STE 114, BOWLING GREEN, KY, 42104

Signature of

Role Plan administrator
Date 2018-09-14
Name of individual signing SHANDA HOPPER
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS INDEPENDENT CASE MANAGEMENT 401(K) P/S PLAN 2017 453566446 2018-06-15 BLUEGRASS INDEPENDENT CASE MANAGEMENT 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 624100
Sponsor’s telephone number 2704386672
Plan sponsor’s address 1725 ASHLEY CIR STE 209, BOWLING GREEN, KY, 42104

Plan administrator’s name and address

Administrator’s EIN 453566446
Plan administrator’s name BLUEGRASS INDEPENDENT CASE MANAGEMENT
Plan administrator’s address 1725 ASHLEY CIR STE 209, BOWLING GREEN, KY, 42104
Administrator’s telephone number 2704386672

Signature of

Role Plan administrator
Date 2018-06-15
Name of individual signing SHANDA HOPPER
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS INDEPENDENT CASE MANAGEMENT 401(K) P/S PLAN 2016 453566446 2017-06-23 BLUEGRASS INDEPENDENT CASE MANAGEMENT 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541990
Sponsor’s telephone number 2704386672
Plan sponsor’s address 1725 ASHLEY CIR STE 209, BOWLING GREEN, KY, 42104

Plan administrator’s name and address

Administrator’s EIN 453566446
Plan administrator’s name BLUEGRASS INDEPENDENT CASE MANAGEMENT
Plan administrator’s address 1725 ASHLEY CIR STE 209, BOWLING GREEN, KY, 42104
Administrator’s telephone number 2704386672

Signature of

Role Plan administrator
Date 2017-06-23
Name of individual signing SHANDA HOPPER
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS INDEPENDENT CASE MANAGEMENT 401(K) P/S PLAN 2015 453566446 2016-05-15 BLUEGRASS INDEPENDENT CASE MANAGEMENT 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541990
Sponsor’s telephone number 2704386672
Plan sponsor’s address 1725 ASHLEY CIR STE 114, BOWLING GREEN, KY, 42104

Plan administrator’s name and address

Administrator’s EIN 453566446
Plan administrator’s name BLUEGRASS INDEPENDENT CASE MANAGEMENT
Plan administrator’s address 1725 ASHLEY CIR STE 114, BOWLING GREEN, KY, 42104
Administrator’s telephone number 2704386672

Signature of

Role Plan administrator
Date 2016-05-15
Name of individual signing SHANDA HOPPER
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS INDEPENDENT CASE MANAGEMENT 401(K) P/S PLAN 2014 453566446 2015-05-06 BLUEGRASS INDEPENDENT CASE MANAGEMENT 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541990
Sponsor’s telephone number 2704386672
Plan sponsor’s address 1725 ASHLEY CIR STE 114, BOWLING GREEN, KY, 42104

Plan administrator’s name and address

Administrator’s EIN 453566446
Plan administrator’s name BLUEGRASS INDEPENDENT CASE MANAGEMENT
Plan administrator’s address 1725 ASHLEY CIR STE 114, BOWLING GREEN, KY, 42104
Administrator’s telephone number 2704386672

Signature of

Role Plan administrator
Date 2015-05-06
Name of individual signing SHANDA HOPPER
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
Thomas Gregory McCane Registered Agent

Organizer

Name Role
Thomas Gregory McCane Organizer
Lori Ann McCane Organizer

Date of last update: 14 Nov 2024

Sources: Kentucky Secretary of State