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  5. KEBERT EYE CLINIC PLLC

KEBERT EYE CLINIC PLLC

Company Details

Name: KEBERT EYE CLINIC PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 17 Sep 2001 (23 years ago)
Business ID: 707062
ZIP code: 39648
County: Pike
State of Incorporation: MISSISSIPPI
Principal Office Address: 1307 ASTON AVENUE, 1307 ASTON AVENUEMCCOMB, MS 39648

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KEBERT EYE CLINIC, PLLC 401(K) PLAN DTD 01/01/2003 2023 640945786 2024-04-29 KEBERT EYE CLINIC, PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2024-04-29
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
KEBERT EYE CLINIC, PLLC 401(K) PLAN DTD 01/01/2003 2022 640945786 2023-06-20 KEBERT EYE CLINIC, PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2023-06-20
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
KEBERT EYE CLINIC, PLLC 401(K) PLAN DTD 01/01/2003 2021 640945786 2022-09-20 KEBERT EYE CLINIC, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2022-09-20
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-20
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
KEBERT EYE CLINIC, PLLC 401(K) PLAN DTD 01/01/2003 2020 640945786 2021-08-10 KEBERT EYE CLINIC, PLLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2021-08-10
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-08-10
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
KEBERT EYE CLINIC, PLLC 401(K) PLAN DTD 01/01/2003 2019 640945786 2020-08-25 KEBERT EYE CLINIC, PLLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2020-08-25
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-25
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
KEBERT EYE CLINIC, PLLC 401(K) PLAN DTD 01/01/2003 2018 640945786 2019-04-12 KEBERT EYE CLINIC, PLLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2019-04-12
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-04-12
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
KEBERT EYE CLINIC, PLLC 401(K) PLAN DTD 01/01/2003 2017 640945786 2018-04-13 KEBERT EYE CLINIC, PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2018-04-13
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-13
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
KEBERT EYE CLINIC, PLLC 401(K) PLAN DTD 01/01/2003 2016 640945786 2017-04-14 KEBERT EYE CLINIC, PLLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2017-04-14
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-04-14
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
KEBERT EYE CLINIC, PLLC 401(K) PLAN 2015 640945786 2016-08-16 KEBERT EYE CLINIC, PLLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2016-08-16
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-16
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
KEBERT EYE CLINIC, PLLC 401(K) PLAN 2014 640945786 2015-07-27 KEBERT EYE CLINIC, PLLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2015-07-27
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-27
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/13/20141013130941P030002587977001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Signature of
Role Plan administrator
Date 2014-10-13
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-13
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/14/20131014093900P040013449717001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Plan sponsor’s DBA name SAME
Plan sponsor’s mailing address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Number of participants as of the end of the plan year
Active participants 13
Number of participants with account balances as of the end of the plan year 12

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-14
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/10/20121010172457P030001054292001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s DBA name SAME
Plan sponsor’s mailing address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Plan administrator’s name and address
Administrator’s EIN 640945786
Plan administrator’s name KEBERT EYE CLINIC PLLC
Plan administrator’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Administrator’s telephone number 6016848118

Number of participants as of the end of the plan year
Active participants 13
Number of participants with account balances as of the end of the plan year 13

Signature of
Role Plan administrator
Date 2012-10-10
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-06
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s mailing address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Plan administrator’s name and address
Administrator’s EIN 640945786
Plan administrator’s name KEBERT EYE CLINIC, PLLC
Plan administrator’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Administrator’s telephone number 6016848118

Number of participants as of the end of the plan year
Active participants 13
Number of participants with account balances as of the end of the plan year 13

Signature of
Role Employer/plan sponsor
Date 2011-09-21
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/28/20110928135048P040639628848001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s mailing address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Plan administrator’s name and address
Administrator’s EIN 640945786
Plan administrator’s name KEBERT EYE CLINIC, PLLC
Plan administrator’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Administrator’s telephone number 6016848118

Number of participants as of the end of the plan year
Active participants 13
Number of participants with account balances as of the end of the plan year 13

Signature of
Role Plan administrator
Date 2011-09-28
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s mailing address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Plan administrator’s name and address
Administrator’s EIN 640945786
Plan administrator’s name KEBERT EYE CLINIC, PLLC
Plan administrator’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Administrator’s telephone number 6016848118

Number of participants as of the end of the plan year
Active participants 13
Number of participants with account balances as of the end of the plan year 13

Signature of
Role Plan administrator
Date 2011-09-23
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/05/20111005183524P030665350464001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s mailing address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Plan administrator’s name and address
Administrator’s EIN 640945786
Plan administrator’s name KEBERT EYE CLINIC, PLLC
Plan administrator’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Administrator’s telephone number 6016848118

Number of participants as of the end of the plan year
Active participants 12
Retired or separated participants receiving benefits 1
Number of participants with account balances as of the end of the plan year 13

Signature of
Role Plan administrator
Date 2011-10-05
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 6016848118
Plan sponsor’s mailing address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Plan sponsor’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648

Plan administrator’s name and address
Administrator’s EIN 640945786
Plan administrator’s name KEBERT EYE CLINIC, PLLC
Plan administrator’s address 1307 ASTON AVENUE, MCCOMB, MS, 39648
Administrator’s telephone number 6016848118

Number of participants as of the end of the plan year
Active participants 12
Retired or separated participants receiving benefits 1
Number of participants with account balances as of the end of the plan year 13

Signature of
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing KENT KEBERT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
KENT L KEBERT MD Agent 1307 ASTON AVENUE, MCCOMB, MS 39648

Member

Name Role Address
KENT L KEBERT Member 1307 ASTON AVENUE, MCCOMB, MS 39648

Manager

Name Role Address
Jessica Rials Manager 1307 ASTON AVE, MCCOMB, MS 39648

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2024-03-07 Annual Report For KEBERT EYE CLINIC PLLC
Annual Report LLC Filed 2023-01-19 Annual Report For KEBERT EYE CLINIC PLLC
Annual Report LLC Filed 2022-04-07 Annual Report For KEBERT EYE CLINIC PLLC
Annual Report LLC Filed 2021-07-26 Annual Report For KEBERT EYE CLINIC PLLC
Annual Report LLC Filed 2020-09-11 Annual Report For KEBERT EYE CLINIC PLLC
Notice to Dissolve/Revoke Filed 2020-08-28 Notice to Dissolve/Revoke
Annual Report LLC Filed 2019-05-21 Annual Report For KEBERT EYE CLINIC PLLC
Annual Report LLC Filed 2018-04-10 Annual Report For KEBERT EYE CLINIC PLLC
Annual Report LLC Filed 2017-03-01 Annual Report For KEBERT EYE CLINIC PLLC
Annual Report LLC Filed 2016-02-08 Annual Report For KEBERT EYE CLINIC PLLC

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 27 Dec 2024

Sources: Mississippi Secretary of State

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