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  5. LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC.

LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC.

Company Details

Entity Name: LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 14 Jun 1977 (48 years ago)
Document Number: 739351
FEI/EIN Number 591769552
Address: 15629 NW CR 12, BRISTOL, FL, 32321
Mail Address: PO BOX 730, BRISTOL, FL, 32321
ZIP code: 32321
County: Liberty
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 2021 591769552 2022-03-29 LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 624200
Sponsor’s telephone number 8506435613
Plan sponsor’s address PO BOX 730, BRISTOL, FL, 323210730

Signature of
Role Plan administrator
Date 2022-03-29
Name of individual signing COLLEEN SHIVER
Valid signature Filed with authorized/valid electronic signature
403 (B) THRIFT PLAN OF LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 2020 591769552 2021-04-15 LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 624200
Sponsor’s telephone number 8506435613
Plan sponsor’s address PO BOX 730, BRISTOL, FL, 323210730

Signature of
Role Plan administrator
Date 2021-04-15
Name of individual signing COLLEEN SHIVER
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 2019 591769552 2020-07-22 LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 624200
Sponsor’s telephone number 8506435613
Plan sponsor’s address PO BOX 730, BRISTOL, FL, 323210730

Signature of
Role Plan administrator
Date 2020-07-22
Name of individual signing COLLEEN SHIVER
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 2018 591769552 2020-07-22 LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 624200
Sponsor’s telephone number 8506435613
Plan sponsor’s address PO BOX 730, BRISTOL, FL, 323210730

Signature of
Role Plan administrator
Date 2020-07-22
Name of individual signing COLLEEN SHIVER
Valid signature Filed with authorized/valid electronic signature
403 B THRIFT PLAN OF LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION INC 2017 591769552 2018-07-31 LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 8506435613
Plan sponsor’s address PO BOX 730, BRISTOL, FL, 323210730

Signature of
Role Plan administrator
Date 2018-07-31
Name of individual signing ANN KINCAID
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC 2009 591769552 2010-04-28 LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC No data
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 8506435613
Plan sponsor’s mailing address P.O. BOX 730, BRISTOL, FL, 32321
Plan sponsor’s address 15629 NW CR 12, BRISTOL, FL, 32321

Plan administrator’s name and address
Administrator’s EIN 591769552
Plan administrator’s name LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC
Plan administrator’s address P.O. BOX 730, BRISTOL, FL, 32321
Administrator’s telephone number 8506435613

Signature of
Role Plan administrator
Date 2010-04-28
Name of individual signing ANN KINCAID
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 2009 591769552 2010-07-19 LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC. 3
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 8506435613
Plan sponsor’s address PO BOX 730, BRISTOL, FL, 32321

Plan administrator’s name and address
Administrator’s EIN 591769552
Plan administrator’s name LIBERTY COUNTY SENIOR CITIZENS ASSOCIATION, INC.
Plan administrator’s address PO BOX 730, BRISTOL, FL, 32321
Administrator’s telephone number 8506435613

Signature of
Role Plan administrator
Date 2010-06-24
Name of individual signing COLLEEN SHIVER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SUMNER RUDY Agent HWY 65 S BOX 72, TELOGIA, FL, 32360

President

Name Role Address
SUMNER RUDY President HWY 65 S PO BOX 72, TELOGIA, FL, 32360

Director

Name Role Address
Money Walter Director 19061 NW ST Rd 12, Bristol, FL, 32321
SHIVER PEGGY Director 2637 NW SR 270, BRISTOL, FL, 32321
Shepard Debbie Director 12729 NW Twin Oaks Drive, Bristol, FL, 32321

Secretary

Name Role Address
Ford Stephen Secretary 11472 NW Ford Farm Trail, Bristol, FL, 32321

Vice President

Name Role Address
Phillips Brett Vice President 6840 NW Torreya Park Rd., Bristol, FL, 32321

Related by officers

Phillips Brett

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Related by address

No related companies by address

Date of last update: 01 Jan 2025

Sources: Florida Department of State

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