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  5. WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC.

WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC. - Florida Company Profile

Company Details

Entity Name: WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 04 Oct 1967 (57 years ago)
Document Number: 713409
FEI/EIN Number 591145224

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 1154 BALDWIN AVE., DEFUNIAK SPGS, FL, 32433, US
Mail Address: 1154 BALDWIN AVE., DEFUNIAK SPGS, FL, 32433, US
ZIP code: 32433
County: Walton
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1982720769 2007-03-22 2023-01-12 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 324352308, US 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 324352308, US

Contacts
Phone +1 850-892-8165
Fax 8508928169

Authorized person
Name MRS. SHAYNE BETTS
Role EXECUTIVE DIRECTOR
Phone 8598928165

Taxonomy
Taxonomy Code 251B00000X - Case Management Agency
Is Primary Yes
Taxonomy Code 253Z00000X - In Home Supportive Care Agency
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 677320600
State FL
Issuer MEDICAID
Number 024864900
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE BENEFIT PLAN OF WALTON COUNTY ADVISORY COUNCIL ON AGING , INC. 2023 591145224 2024-10-09 WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-09-01
Business code 624200
Plan sponsor’s address 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 324352308

Signature of
Role Plan administrator
Date 2024-10-09
Name of individual signing KYLE TEBBS
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WALTON COUNTY ADVISORY COUNCIL ON AGING, INC 2022 591145224 2024-10-01 WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-09-01
Business code 624200
Sponsor’s telephone number 8508928165
Plan sponsor’s DBA name WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING
Plan sponsor’s address 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 324352308

Signature of
Role Plan administrator
Date 2024-10-01
Name of individual signing KYLE TEBBS
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC. 2020 591145224 2021-06-18 WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-09-01
Business code 624200
Sponsor’s telephone number 8508928165
Plan sponsor’s address 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 324359500

Signature of
Role Plan administrator
Date 2021-06-18
Name of individual signing SHAYNE BETTS
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC. 2019 591145224 2020-06-10 WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC. 15
Three-digit plan number (PN) 001
Effective date of plan 2003-09-01
Business code 624200
Sponsor’s telephone number 8508928165
Plan sponsor’s address 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 324359500

Signature of
Role Plan administrator
Date 2020-06-10
Name of individual signing SHAYNE BETTS
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC. 2019 591145224 2020-06-10 WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-09-01
Business code 624200
Sponsor’s telephone number 8508928165
Plan sponsor’s address 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 324359500

Signature of
Role Plan administrator
Date 2020-06-10
Name of individual signing SHAYNE BETTS
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC. 2018 591145224 2019-07-24 WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-09-01
Business code 624200
Sponsor’s telephone number 8508928165
Plan sponsor’s address 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 324359500

Signature of
Role Plan administrator
Date 2019-07-24
Name of individual signing KAY BRADY
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC 2017 591145224 2019-09-13 WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING INC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-09-01
Business code 624100
Plan sponsor’s address 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 324352308

Signature of
Role Plan administrator
Date 2019-09-13
Name of individual signing KAY BRADY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-13
Name of individual signing KAY BRADY
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
Brackins Alicia DDirecto Manager 1154 BALDWIN AVE., DEFUNIAK SPRINGS, FL, 32435
Newsome Lothar Treasurer 1154 BALDWIN AVE., DEFUNIAK SPGS, FL, 32435
Burgess Chris Chairman 1154 Baldwin Ave, Defuniak Springs, FL
Brackins Alicia DDirecto Agent 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 32435

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000057124 EMERALD COAST COUNCIL ON AGING ACTIVE 2024-04-30 2029-12-31 - 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 32435
G12000030853 WALTON OKALOOSA COUNCIL ON AGING ACTIVE 2012-03-29 2027-12-31 - 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL, 32435

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-11-19 Brackins, Alicia D, Director -
CHANGE OF MAILING ADDRESS 2021-03-06 1154 BALDWIN AVE., DEFUNIAK SPGS, FL 32433 -
REGISTERED AGENT ADDRESS CHANGED 2012-01-03 1154 BALDWIN AVE, DEFUNIAK SPRINGS, FL 32435 -
CHANGE OF PRINCIPAL ADDRESS 2009-03-02 1154 BALDWIN AVE., DEFUNIAK SPGS, FL 32433 -

Documents

Name Date
AMENDED ANNUAL REPORT 2024-11-19
ANNUAL REPORT 2024-03-01
ANNUAL REPORT 2023-01-22
ANNUAL REPORT 2022-01-31
ANNUAL REPORT 2021-03-06
ANNUAL REPORT 2020-03-09
ANNUAL REPORT 2019-02-07
ANNUAL REPORT 2018-01-25
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-02-01

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-1145224 Corporation Unconditional Exemption 1154 BALDWIN AVE, DEFUNIAK SPGS, FL, 32435-2308 2002-10
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-12
Asset 1,000,000 to 4,999,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 1582644
Income Amount 1519232
Form 990 Revenue Amount 1519232
National Taxonomy of Exempt Entities Human Services: Centers to Support the Independence of Specific Populations
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING INC
EIN 59-1145224
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING INC
EIN 59-1145224
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING INC
EIN 59-1145224
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING INC
EIN 59-1145224
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING INC
EIN 59-1145224
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING INC
EIN 59-1145224
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING INC
EIN 59-1145224
Tax Period 201512
Filing Type E
Return Type 990
File View File

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No other companies in our directory share the same address as WALTON COUNTY CITIZENS ADVISORY COUNCIL ON AGING, INC.

Date of last update: 03 Mar 2025

Sources: Florida Department of State

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