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KING'S DAUGHTERS HOSPITAL

Company Details

Name: KING'S DAUGHTERS HOSPITAL
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Effective Date: 14 Oct 1914 (110 years ago)
Business ID: 586140
State of Incorporation: MISSISSIPPI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KING'S DAUGHTERS HOSPITAL 403B PLAN 2021 640844470 2022-10-13 KING'S DAUGHTERS HOSPITAL 76
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Signature of
Role Plan administrator
Date 2022-10-13
Name of individual signing REBECCA NORMAN
Valid signature Filed with authorized/valid electronic signature
KING'S DAUGHTERS HOSPITAL 403B PLAN 2020 640844470 2021-10-15 KING'S DAUGHTERS HOSPITAL 85
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing REBECCA NORMAN
Valid signature Filed with authorized/valid electronic signature
KING'S DAUGHTERS HOSPITAL 403B PLAN 2019 640844470 2020-10-08 KING'S DAUGHTERS HOSPITAL 87
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Signature of
Role Plan administrator
Date 2020-10-08
Name of individual signing STEPHANIE WASHINGTON
Valid signature Filed with authorized/valid electronic signature
KING'S DAUGHTERS HOSPITAL 403B PLAN 2018 640844470 2019-10-07 KING'S DAUGHTERS HOSPITAL 100
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Signature of
Role Plan administrator
Date 2019-10-07
Name of individual signing STEPHANIE WASHINGTON
Valid signature Filed with authorized/valid electronic signature
KING'S DAUGHTERS HOSPITAL PROFIT SHARING PLAN 2017 640844470 2018-06-06 KING'S DAUGHTERS HOSPITAL 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-03-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Signature of
Role Plan administrator
Date 2018-06-06
Name of individual signing STEPHANIE WASHINGTON
Valid signature Filed with authorized/valid electronic signature
KING'S DAUGHTERS HOSPITAL PROFIT SHARING PLAN 2016 640844470 2017-10-13 KING'S DAUGHTERS HOSPITAL 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-03-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing SEAN JOHNSON
Valid signature Filed with authorized/valid electronic signature
KING'S DAUGHTERS HOSPITAL PROFIT SHARING PLAN 2015 640844470 2016-10-12 KING'S DAUGHTERS HOSPITAL 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-03-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing SEAN JOHNSON
Valid signature Filed with authorized/valid electronic signature
KING'S DAUGHTERS HOSPITAL OF YAZOO 2014 640844470 2015-12-29 KING'S DAUGHTERS HOSPITAL 131
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2008-04-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s mailing address 823 GRAND AVENUE, YAZOO CITY, MS, 39194
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 39194

Number of participants as of the end of the plan year
Active participants 124

Signature of
Role Plan administrator
Date 2015-12-29
Name of individual signing STEPHANIE WASHINGTON
Valid signature Filed with authorized/valid electronic signature
KING'S DAUGHTERS HOSPITAL OF YAZOO 2014 640844470 2015-12-16 KING'S DAUGHTERS HOSPITAL 134
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2008-04-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s mailing address 823 GRAND AVENUE, YAZOO CITY, MS, 39194
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 39194

Number of participants as of the end of the plan year
Active participants 127

Signature of
Role Plan administrator
Date 2015-12-16
Name of individual signing STEPHANIE WASHINGTON
Valid signature Filed with authorized/valid electronic signature
KING'S DAUGHTERS HOSPITAL OF YAZOO 2014 640844470 2015-12-16 KING'S DAUGHTERS HOSPITAL 140
File View Page
Three-digit plan number (PN) 505
Effective date of plan 2012-04-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s mailing address 823 GRAND AVENUE, YAZOO CITY, MS, 39194
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 39194

Number of participants as of the end of the plan year
Active participants 134

Signature of
Role Plan administrator
Date 2015-12-16
Name of individual signing STEPHANIE WASHINGTON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/13/20151013105244P030045367137001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1989-03-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing SEAN JOHNSON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/02/20141002100319P040001523417001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1989-03-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Signature of
Role Plan administrator
Date 2014-10-02
Name of individual signing SEAN JOHNSON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/17/20130717154452P030110762565001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1989-03-01
Business code 622000
Sponsor’s telephone number 6627462261
Plan sponsor’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233

Plan administrator’s name and address
Administrator’s EIN 640844470
Plan administrator’s name DARYL WEAVER
Plan administrator’s address 823 GRAND AVENUE, YAZOO CITY, MS, 391943233
Administrator’s telephone number 6627462261

Signature of
Role Plan administrator
Date 2013-07-17
Name of individual signing DARYL WEAVER
Valid signature Filed with authorized/valid electronic signature

Incorporator

Name Role Address
MARY BOWEN Incorporator B, BROOKHAVEN, MS
MARY HARTMAN Incorporator B, BROOKHAVEN, MS
MARY MCNAIR Incorporator B, BROOKHAVEN, MS

Filings

Type Status Filed Date Description
Amendment Form Filed 1999-01-11 Amendment

Related by officers

MARY BOWEN

KINGS DAUGHTERS HOSPITAL

MARY HARTMAN

KINGS DAUGHTERS HOSPITAL

MARY MCNAIR

KINGS DAUGHTERS HOSPITAL

Related by address

No related companies by address

Date of last update: 05 Feb 2025

Sources: Mississippi Secretary of State

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