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  5. CITIZENS STATE BANK

CITIZENS STATE BANK

Company Details

Entity Name: CITIZENS STATE BANK
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 15 Jan 1958 (67 years ago)
Document Number: 209089
FEI/EIN Number 590828474
Address: 2000 S BYRON BUTLER PKWY, PERRY, FL, 32348, US
Mail Address: PO BOX 143060, Gainesville, FL, 32614, US
ZIP code: 32348
County: Taylor
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CITIZENS BANK OF PERRY PROFIT SHARING AND 401(K) PLAN 2013 590828474 2015-11-11 CITIZENS STATE BANK 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 522110
Sponsor’s telephone number 8505844411
Plan sponsor’s address 2000 SOUTH BYRON PARKWAY, PERRY, FL, 32348

Signature of
Role Plan administrator
Date 2015-11-11
Name of individual signing JENNIFER HORN
Valid signature Filed with authorized/valid electronic signature
CITIZENS BANK OF PERRY PROFIT SHARING AND 401(K) PLAN 2012 590828474 2013-10-09 CITIZENS STATE BANK 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 522110
Sponsor’s telephone number 8505844411
Plan sponsor’s address 2000 SOUTH BYRON PARKWAY, PERRY, FL, 32348

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing ROGER BROOKS
Valid signature Filed with authorized/valid electronic signature
CITIZENS BANK OF PERRY PROFIT SHARING AND 401(K) PLAN 2011 590828474 2012-10-15 CITIZENS STATE BANK 36
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 522110
Sponsor’s telephone number 8505844411
Plan sponsor’s address 2000 SOUTH BYRON PARKWAY, PERRY, FL, 32348

Plan administrator’s name and address
Administrator’s EIN 590828474
Plan administrator’s name CITIZENS STATE BANK
Plan administrator’s address 2000 SOUTH BYRON PARKWAY, PERRY, FL, 32348
Administrator’s telephone number 8505844411

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing ROGER BROOKS
Valid signature Filed with authorized/valid electronic signature
CITIZENS BANK OF PERRY PROFIT SHARING AND 401(K) PLAN 2011 590828474 2013-02-27 CITIZENS STATE BANK 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 522110
Sponsor’s telephone number 8505844411
Plan sponsor’s address 2000 SOUTH BYRON PARKWAY, PERRY, FL, 32348

Plan administrator’s name and address
Administrator’s EIN 590828474
Plan administrator’s name CITIZENS STATE BANK
Plan administrator’s address 2000 SOUTH BYRON PARKWAY, PERRY, FL, 32348
Administrator’s telephone number 8505844411

Signature of
Role Plan administrator
Date 2013-02-26
Name of individual signing ROGER BROOKS
Valid signature Filed with authorized/valid electronic signature
CITIZENS BANK OF PERRY PROFIT SHARING AND 401(K) PLAN 2010 590828474 2011-10-13 CITIZENS STATE BANK 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1973-01-01
Business code 522110
Sponsor’s telephone number 8505844411
Plan sponsor’s address 2000 SOUTH BYRON PARKWAY, PERRY, FL, 32348

Plan administrator’s name and address
Administrator’s EIN 590828474
Plan administrator’s name CITIZENS STATE BANK
Plan administrator’s address 2000 SOUTH BYRON PARKWAY, PERRY, FL, 32348
Administrator’s telephone number 8505844411

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing ROGER BROOKS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Levy Gilbert A Agent 13840 W. Newberry Rd., Newberry, FL, 32669

Secretary

Name Role Address
PACK NICOLLE R Secretary 13840 W. Newberry Rd., Newberry, FL, 32669

President

Name Role Address
LEVY GILBERT President 13840 W. Newberry Rd., Newberry, FL, 32669

CBD

Name Role Address
DICKERT MARK CBD 13840 W. Newberry Rd., Newberry, FL, 32669

Chief Operating Officer

Name Role Address
Crum Brian Chief Operating Officer 13840 W. Newberry Rd., Newberry, FL, 32669

Chief Financial Officer

Name Role Address
Robinson B B Chief Financial Officer 13840 W. Newberry Road, Newberry, FL, 32669

Events

Event Type Filed Date Value Description
MERGER 2019-08-02 No data CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 700000195057
NAME CHANGE AMENDMENT 2007-03-15 CITIZENS STATE BANK No data

Related by officers

LEVY GILBERT

ANDRESALL, INC. SABORE, LLC JONESVILLE PLAZA, LLC TIMELESS INTERIORS, INC. GALIANI CORPORATION TIOGA TOWN CENTER, LLC

DICKERT MARK

PERRY SUCCESSOR BANK PBC FINANCIAL SERVICES, INC.

Crum Brian

PERRY SUCCESSOR BANK FOREST STREET NEIGHBORHOOD ASSOCIATION, INC.

Levy Gilbert A

PERRY SUCCESSOR BANK

Related by address

2000 S BYRON BUTLER PKWY, PERRY, FL, 32348, US

PERRY SUCCESSOR BANK

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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