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  5. WASHINGTON COUNTY COUNCIL ON AGING, INC

WASHINGTON COUNTY COUNCIL ON AGING, INC - Florida Company Profile

Company Details

Entity Name: WASHINGTON COUNTY 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: 06 Apr 1973 (52 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 26 Apr 2024 (a year ago)
Document Number: 726022
FEI/EIN Number 591485912

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 1348 SOUTH BLVD., CHIPLEY, FL, 32428, US
Mail Address: 1348 SOUTH BLVD., CHIPLEY, FL, 32428, US
ZIP code: 32428
County: Washington
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1629274659 2007-06-26 2023-04-28 1348 SOUTH BLVD, CHIPLEY, FL, 324281846, US 1348 SOUTH BLVD, CHIPLEY, FL, 324281846, US

Contacts
Phone +1 850-638-6217
Fax 8506386363

Authorized person
Name TRACEY LONG
Role EXECUTIVE DIRECTOR
Phone 8506386217

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

Other Provider Identifiers
Issuer MEDICAID
Number 024869000
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING, INC. 2021 591485912 2022-08-15 WASHINGTON COUNTY COUNCIL ON AGING, INC. 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624200
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 324281846

Signature of
Role Plan administrator
Date 2022-08-15
Name of individual signing TRACEY LONG
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING, INC. 2020 591485912 2021-07-30 WASHINGTON COUNTY COUNCIL ON AGING, INC. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624200
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 324281846

Signature of
Role Plan administrator
Date 2021-07-30
Name of individual signing TAYLER AMERSON
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING, INC. 2019 591485912 2020-09-03 WASHINGTON COUNTY COUNCIL ON AGING, INC. 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624200
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 324281846

Signature of
Role Plan administrator
Date 2020-09-03
Name of individual signing ANITA CLARKE
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING, INC. 2018 591485912 2020-09-03 WASHINGTON COUNTY COUNCIL ON AGING, INC. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624200
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 324281846

Signature of
Role Plan administrator
Date 2020-09-03
Name of individual signing ANITA CLARKE
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING INC 2017 591485912 2018-06-29 WASHINGTON COUNTY COUNCIL ON AGING INC 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624100
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 324281846

Signature of
Role Plan administrator
Date 2018-06-29
Name of individual signing ANITA CLARKE
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING, INC. 2016 591485912 2017-07-19 WASHINGTON COUNTY COUNCIL ON AGING, INC. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624100
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 32428

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing ANITA INGERSOLL
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING, INC. 2015 591485912 2016-07-26 WASHINGTON COUNTY COUNCIL ON AGING, INC. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624100
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 32428

Signature of
Role Plan administrator
Date 2016-07-26
Name of individual signing ANITA INGERSOLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-26
Name of individual signing ANITA INGERSOLL
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING, INC. 2014 591485912 2015-07-06 WASHINGTON COUNTY COUNCIL ON AGING, INC. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624100
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 32428

Signature of
Role Plan administrator
Date 2015-07-06
Name of individual signing ANITA INGERSOLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-06
Name of individual signing ANITA INGERSOLL
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING, INC. 2013 591485912 2014-07-02 WASHINGTON COUNTY COUNCIL ON AGING, INC. 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624100
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 32428

Signature of
Role Plan administrator
Date 2014-07-02
Name of individual signing ANITA INGERSOLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-02
Name of individual signing ANITA INGERSOLL
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF WASHINGTON COUNTY COUNCIL ON AGING, INC. 2012 591485912 2013-07-31 WASHINGTON COUNTY COUNCIL ON AGING, INC. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-07-01
Business code 624100
Sponsor’s telephone number 8506386216
Plan sponsor’s address 1348 SOUTH BLVD, CHIPLEY, FL, 32428

Signature of
Role Plan administrator
Date 2013-07-31
Name of individual signing ANITA INGERSOLL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-31
Name of individual signing ANITA INGERSOLL
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
BROWN MILTON Officer 3399 MALLORY ROAD, VERNON, FL, 32462
RAY MARLENE Officer 819 3RD STREET, CHIPLEY, FL, 32428
LEWIS JAMES President 925 HURST COURT, PANAMA CITY, FL, 32404
Willis Patricia Director 1348 SOUTH BLVD., CHIPLEY, FL, 32428
Willis Patricia Agent 1348 SOUTH BLVD., CHIPLEY, FL, 32428

Events

Event Type Filed Date Value Description
REINSTATEMENT 2024-04-26 - -
REGISTERED AGENT NAME CHANGED 2024-04-26 Willis, Patricia -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 - -
CHANGE OF MAILING ADDRESS 2008-03-12 1348 SOUTH BLVD., CHIPLEY, FL 32428 -
CHANGE OF PRINCIPAL ADDRESS 1997-05-30 1348 SOUTH BLVD., CHIPLEY, FL 32428 -
REGISTERED AGENT ADDRESS CHANGED 1997-05-30 1348 SOUTH BLVD., CHIPLEY, FL 32428 -
AMENDMENT 1992-01-22 - -

Documents

Name Date
REINSTATEMENT 2024-04-26
ANNUAL REPORT 2022-01-27
ANNUAL REPORT 2021-04-22
ANNUAL REPORT 2020-01-22
ANNUAL REPORT 2019-02-27
ANNUAL REPORT 2018-04-02
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-02-22
ANNUAL REPORT 2015-03-09
ANNUAL REPORT 2014-03-12

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-1485912 Corporation Unconditional Exemption 1348 SOUTH BLVD, CHIPLEY, FL, 32428-1846 1975-09
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, Educational Organization, Local Association of Employees, Agricultural Organization, Horticultural Organization, Board of Trade, Business League, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Voluntary Employees' Beneficiary Association (Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Mutual Ditch or Irrigation Co., Burial Association, Cemetery Company, Credit Union, Other Mutual Corp. or Assoc., 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 25,000 to 99,999
Income 500,000 to 999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 90410
Income Amount 869000
Form 990 Revenue Amount 869000
National Taxonomy of Exempt Entities -
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 WASHINGTON COUNTY COUNCIL ON AGING
EIN 59-1485912
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name WASHINGTON COUNTY COUNCIL ON AGING
EIN 59-1485912
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name WASHINGTON COUNTY COUNCIL ON AGING
EIN 59-1485912
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name WASHINGTON COUNTY COUNCIL ON AGING
EIN 59-1485912
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name WASHINGTON COUNTY COUNCIL ON AGING
EIN 59-1485912
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name WASHINGTON COUNTY COUNCIL ON AGING
EIN 59-1485912
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name WASHINGTON COUNTY COUNCIL ON AGING
EIN 59-1485912
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name WASHINGTON COUNTY COUNCIL ON AGING
EIN 59-1485912
Tax Period 201512
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1726217100 2020-04-10 0491 PPP 1348 South Blvd, Chipley, FL, 32428-1846
Loan Status Date 2021-05-25
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 112893.72
Loan Approval Amount (current) 104811.87
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17652
Servicing Lender Name Capital City Bank
Servicing Lender Address 217 N Monroe St, TALLAHASSEE, FL, 32301-7619
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Chipley, WASHINGTON, FL, 32428-1846
Project Congressional District FL-02
Number of Employees 28
NAICS code 624120
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 17652
Originating Lender Name Capital City Bank
Originating Lender Address TALLAHASSEE, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 105793.94
Forgiveness Paid Date 2021-04-08

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Willis Patricia

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Companies related by address

No other companies in our directory share the same address as WASHINGTON COUNTY COUNCIL ON AGING, INC

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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