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  5. MICAH CAMPBELL INSURANCE SERVICES LLC

MICAH CAMPBELL INSURANCE SERVICES LLC

Company Details

Name: MICAH CAMPBELL INSURANCE SERVICES LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 01 Apr 2013 (12 years ago)
Organization Date: 01 Apr 2013 (12 years ago)
Last Annual Report: 20 Feb 2025 (2 months ago)
Managed By: Members
Organization Number: 0853981
Industry: Insurance Agents, Brokers and Service
Number of Employees: Small (0-19)
ZIP code: 40361
City: Paris
Primary County: Bourbon County
Principal Office: 1438 SOUTH HIGH STREET, PARIS, KY 40361
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MICAH CAMPBELL INSURANCE SERVICES, LLC 401(K) PLAN 2023 462400043 2024-07-22 MICAH CAMPBELL INSURANCE SERVICES, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8599873906
Plan sponsor’s address 317 HOUSTON CREEK DRIVE, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2024-07-20
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-20
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
MICAH CAMPBELL INSURANCE SERVICES, LLC 401(K) PLAN 2022 462400043 2023-07-19 MICAH CAMPBELL INSURANCE SERVICES, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8599873906
Plan sponsor’s address 122 SQUIRES POINTE ROAD, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2023-07-17
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-17
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
MICAH CAMPBELL INSURANCE SERIVCES, LLC 401(K) PLAN 2021 462400043 2022-07-29 MICAH CAMPBELL INSURANCE SERVICES, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8599873906
Plan sponsor’s address 122 SQUIRES POINTE ROAD, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2022-07-23
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
MICAH CAMPBELL INSURANCE SERIVCES, LLC 401(K) PLAN 2020 462400043 2021-07-29 MICAH CAMPBELL INSURANCE SERVICES, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8599873906
Plan sponsor’s address 122 SQUIRES POINTE ROAD, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2021-07-28
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-28
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
MICAH CAMPBELL INSURANCE SERIVCES, LLC 401(K) PLAN 2019 462400043 2020-07-24 MICAH CAMPBELL INSURANCE SERVICES, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8599873906
Plan sponsor’s address 122 SQUIRES POINTE ROAD, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2020-07-23
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-23
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
MICAH CAMPBELL INSURANCE SERIVCES, LLC 401(K) PLAN 2018 462400043 2019-07-25 MICAH CAMPBELL INSURANCE SERVICES, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8599873906
Plan sponsor’s address 122 SQUIRES POINTE ROAD, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2019-07-23
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-23
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
MICAH CAMPBELL INSURANCE SERIVCES, LLC 401(K) PLAN 2017 462400043 2018-07-31 MICAH CAMPBELL INSURANCE SERVICES, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8599873906
Plan sponsor’s mailing address 122 SQUIRES POINTE ROAD, PARIS, KY, 40361
Plan sponsor’s address 1438 SOUTH HIGH STREET, PARIS, KY, 40361

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2018-07-21
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-21
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
MICAH CAMPBELL INSURANCE SERIVCES, LLC 401(K) PLAN 2016 462400043 2017-07-26 MICAH CAMPBELL INSURANCE SERVICES, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8592649707
Plan sponsor’s mailing address 122 SQUIRES POINTE ROAD, PARIS, KY, 40361
Plan sponsor’s address 1438 SOUTH HIGH STREET, PARIS, KY, 40361

Number of participants as of the end of the plan year
Active participants 5
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 5
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-07-14
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-14
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
MICAH CAMPBELL INSURANCE SERIVCES, LLC 401(K) PLAN 2015 462400043 2016-07-27 MICAH CAMPBELL INSURANCE SERVICES, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8592649707
Plan sponsor’s mailing address 122 SQUIRES POINTE ROAD, PARIS, KY, 40361
Plan sponsor’s address 1438 SOUTH HIGH STREET, PARIS, KY, 40361

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2016-07-15
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-15
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
MICAH CAMPBELL INSURANCE SERIVCES, LLC 401(K) PLAN 2014 462400043 2015-07-21 MICAH CAMPBELL INSURANCE SERVICES, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8592649707
Plan sponsor’s mailing address 1438 SOUTH HIGH STREET, PARIS, KY, 40361
Plan sponsor’s address 1438 SOUTH HIGH STREET, PARIS, KY, 40361

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2015-06-15
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-15
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/30/20140730130005P030021083359006.pdf
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524210
Sponsor’s telephone number 8592649707
Plan sponsor’s mailing address 1438 SOUTH HIGH STREET, PARIS, KY, 40361
Plan sponsor’s address 1438 SOUTH HIGH STREET, PARIS, KY, 40361

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2014-07-19
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-19
Name of individual signing MICAH L. CAMPBELL
Valid signature Filed with authorized/valid electronic signature

Organizer

Name Role
MICAH CAMPBELL Organizer

Registered Agent

Name Role
MICAH CAMPBELL Registered Agent

Member

Name Role
MICAH CAMPBELL Member

Licenses

Department License Number License Type / Line of Authority Status Issue Date Effective Date Inactive Date Expiry Date Address
Department of Insurance DOI ID 808467 Agent - Life Active 2013-04-21 - - 2027-03-31 -
Department of Insurance DOI ID 808467 Agent - Health Active 2013-04-21 - - 2027-03-31 -
Department of Insurance DOI ID 808467 Agent - Casualty Active 2013-04-21 - - 2027-03-31 -
Department of Insurance DOI ID 808467 Agent - Property Active 2013-04-21 - - 2027-03-31 -

Filings

Name File Date
Annual Report 2025-02-20
Annual Report 2024-03-20
Annual Report 2023-05-17
Annual Report 2022-03-14
Annual Report 2021-05-10
Annual Report 2020-03-03
Annual Report 2019-05-09
Annual Report 2018-04-04
Annual Report 2017-03-21
Annual Report 2016-03-15

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7501887000 2020-04-07 0457 PPP 122 Squires Pointe RD, PARIS, KY, 40361-9029
Loan Status Date 2021-03-10
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 76800
Loan Approval Amount (current) 76800
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27569
Servicing Lender Name Stock Yards Bank & Trust Company
Servicing Lender Address 1040 E Main St, LOUISVILLE, KY, 40206-1856
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address PARIS, BOURBON, KY, 40361-9029
Project Congressional District KY-06
Number of Employees 8
NAICS code 524210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 27707
Originating Lender Name Stock Yards Bank & Trust Company
Originating Lender Address PARIS, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 77435.44
Forgiveness Paid Date 2021-02-11

Related by officers

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Related by address

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Sources: Kentucky Secretary of State

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