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  5. PICAYUNE EYE CLINIC, P.A.

PICAYUNE EYE CLINIC, P.A.

Company Details

Name: PICAYUNE EYE CLINIC, P.A.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Good Standing
Effective Date: 11 Sep 1990 (35 years ago)
Business ID: 574799
ZIP code: 39466
County: Pearl River
State of Incorporation: MISSISSIPPI
Principal Office Address: 908 6TH AVEPICAYUNE, MS 39466

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PICAYUNE EYE CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2023 640789939 2024-10-14 PICAYUNE EYE CLINIC, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 6015904015
Plan sponsor’s address 908 SIXTH AVENUE, PICAYUNE, MS, 39466

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing STEPHANIE NETTLES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-14
Name of individual signing STEPHANIE NETTLES
Valid signature Filed with authorized/valid electronic signature
PICAYUNE EYE CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2022 640789939 2023-10-13 PICAYUNE EYE CLINIC, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 6015904015
Plan sponsor’s address 700 PINE STREET, PICAYUNE, MS, 39466

Signature of
Role Plan administrator
Date 2023-10-13
Name of individual signing STEPHANIE NETTLES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-13
Name of individual signing STEPHANIE NETTLES
Valid signature Filed with authorized/valid electronic signature
PICAYUNE EYE CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2021 640789939 2022-09-22 PICAYUNE EYE CLINIC, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 6015904015
Plan sponsor’s address 700 PINE STREET, PICAYUNE, MS, 39466

Signature of
Role Plan administrator
Date 2022-09-22
Name of individual signing STEPHANIE NETTLES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-22
Name of individual signing STEPHANIE NETTLES
Valid signature Filed with authorized/valid electronic signature
PICAYUNE EYE CLINIC, P.A. 401(K) PROFIT SHARING PLAN 2020 640789939 2021-10-07 PICAYUNE EYE CLINIC, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 6015904015
Plan sponsor’s address 700 PINE STREET, PICAYUNE, MS, 39466

Signature of
Role Plan administrator
Date 2021-10-07
Name of individual signing STEPHANIE NETTLES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-07
Name of individual signing STEPHANIE NETTLES
Valid signature Filed with authorized/valid electronic signature

Incorporator

Name Role Address
Lori L Blackmer Incorporator 908 6th Avenue, Picayune, MS 39466

Director

Name Role Address
Lori L Blackmer Director 908 6th Avenue, Picayune, MS 39466

President

Name Role Address
Lori L Blackmer President 908 6th Avenue, Picayune, MS 39466

Agent

Name Role Address
LORI L BLACKMER Agent 908 6TH AVENUE, PICAYUNE, MS 39466

Filings

Type Status Filed Date Description
Annual Report Filed 2025-02-04 Annual Report For PICAYUNE EYE CLINIC, P.A.
Annual Report Filed 2024-03-07 Annual Report For PICAYUNE EYE CLINIC, P.A.
Annual Report Filed 2023-03-24 Annual Report For PICAYUNE EYE CLINIC, P.A.
Annual Report Filed 2022-03-08 Annual Report For PICAYUNE EYE CLINIC, P.A.
Annual Report Filed 2021-02-05 Annual Report For PICAYUNE EYE CLINIC, P.A.
Annual Report Filed 2020-04-15 Annual Report For PICAYUNE EYE CLINIC, P.A.
Annual Report Filed 2019-09-03 Annual Report For PICAYUNE EYE CLINIC, P.A.
Notice to Dissolve/Revoke Filed 2019-08-22 Notice to Dissolve/Revoke
Annual Report Filed 2018-03-28 Annual Report For PICAYUNE EYE CLINIC, P.A.
Annual Report Filed 2017-04-15 Annual Report For PICAYUNE EYE CLINIC, P.A.

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4493157010 2020-04-03 0470 PPP 908 6th Ave, PICAYUNE, MS, 39466-3802
Loan Status Date 2021-02-12
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 101800
Loan Approval Amount (current) 101750
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39682
Servicing Lender Name FNB Picayune Bank
Servicing Lender Address 121 E Canal St, PICAYUNE, MS, 39466-4505
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address PICAYUNE, PEARL RIVER, MS, 39466-3802
Project Congressional District MS-04
Number of Employees 14
NAICS code 621320
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 39682
Originating Lender Name FNB Picayune Bank
Originating Lender Address PICAYUNE, MS
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 102502.67
Forgiveness Paid Date 2021-01-11

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Date of last update: 21 Apr 2025

Sources: Mississippi Secretary of State

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