DAVID S. BLACKETT D.D.S., P.S.

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Company Details

Legal Name:	DAVID S. BLACKETT D.D.S., P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	June 15th 2003
Expiration date:	30 Jun 2026
UBI Number:	602 301 528
ZIP code:	98541
City:	Elma
County:	GRAYS HARBOR
Home State:	WASHINGTON
Principal Office Street Address:	615 W. WALDRIP ST, ELMA, WA, 98541, UNITED STATES
Principal Office Mailing Address:	PO BOX 3034, ELMA, WA, 98541, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$13,621

Contact Details

E-Mail:	BLACKETT@JUNO.COM
Phone Number:	+1 360-482-4000

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name	Role	Address
DAVID S BLACKETT	Registered Agent	615 W WALDRIP ST, ELMA, WA, 98541-0000, UNITED STATES

Key Officers & Management

Name	Role
DAVID BLACKETT	Governing Person

Form 5500 Series

Employer Identification Number (EIN):

651190490

Plan Year:

2024

Number Of Participants:

8

Plan Name:

401(K)

Sponsor's telephone number:

3604824000

File:

Plan Administrator / Signatory:

DAVID S BLACKETT(Plan administrator) DAVID BLACKETT(Employer/plan sponsor)

Plan Year:

2023

Number Of Participants:

6

Plan Name:

401(K)

Sponsor's telephone number:

3604824000

File:

Plan Administrator / Signatory:

DAVID S BLACKETT(Plan administrator) DAVID BLACKETT(Employer/plan sponsor)

Plan Year:

2022

Number Of Participants:

6

Plan Name:

401(K)

Sponsor's telephone number:

3604824000

File:

Plan Administrator / Signatory:

DAVID BLACKETT(Plan administrator) DAVID BLACKETT(Employer/plan sponsor)

Plan Year:

2021

Number Of Participants:

6

Plan Name:

401(K)

Sponsor's telephone number:

3604824000

File:

Plan Administrator / Signatory:

DAVID BLACKETT(Plan administrator) DAVID BLACKETT(Employer/plan sponsor)

Plan Year:

2020

Number Of Participants:

6

Plan Name:

401(K)

Sponsor's telephone number:

3604824000

File:

Plan Administrator / Signatory:

DAVID BLACKETT(Plan administrator) DAVID BLACKETT(Employer/plan sponsor)

Paycheck Protection Program

Jobs Reported:

7

Initial Approval Amount:

$55,543.55

Date Approved:

2021-01-21

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$55,543.55

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$55,957.46

Servicing Lender:

Timberland Bank

Use of Proceeds:

Payroll: $55,543.55

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