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  5. BOLLENBACK & FORRET, P. A.

BOLLENBACK & FORRET, P. A.

Company Details

Entity Name: BOLLENBACK & FORRET, P. A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 11 Dec 1981 (43 years ago)
Document Number: F58075
FEI/EIN Number 592134908
Address: 1000 PINELLAS STREET, CLEARWATER, FL, 33756, US
Mail Address: 1000 PINELLAS STREET, CLEARWATER, FL, 33756, US
ZIP code: 33756
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BOLLENBACK & FORRET, PA 401(K) RETIREMENT PLAN 2023 592134908 2024-06-17 BOLLENBACK & FORRET, P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433
BOLLENBACK & FORRET, PA 401(K) RETIREMENT PLAN 2022 592134908 2023-10-16 BOLLENBACK & FORRET, P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing SUZANNE PATRICK
Valid signature Filed with authorized/valid electronic signature
BOLLENBACK & FORRET, PA 401(K) RETIREMENT PLAN 2021 592134908 2022-09-09 BOLLENBACK & FORRET, P.A. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433

Signature of
Role Plan administrator
Date 2022-08-12
Name of individual signing SUZANNE PATRICK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-08-12
Name of individual signing SUZANNE PATRICK
Valid signature Filed with authorized/valid electronic signature
BOLLENBACK & FORRET, PA 401(K) RETIREMENT PLAN 2020 592134908 2021-06-23 BOLLENBACK & FORRET, P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433

Signature of
Role Plan administrator
Date 2021-06-23
Name of individual signing MICHAEL D. BOLLENBACK
Valid signature Filed with authorized/valid electronic signature
BOLLENBACK & FORRET, P.A. 401(K) RETIREMENT PLAN 2019 592134908 2020-09-03 BOLLENBACK & FORRET, P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433

Signature of
Role Plan administrator
Date 2020-09-03
Name of individual signing MICHAEL D. BOLLENBACK
Valid signature Filed with authorized/valid electronic signature
BOLLENBACK & FORRET, P.A. 401(K) RETIREMENT PLAN 2018 592134908 2019-07-12 BOLLENBACK & FORRET, P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433

Signature of
Role Plan administrator
Date 2019-07-12
Name of individual signing MICHAEL D. BOLLENBACK
Valid signature Filed with authorized/valid electronic signature
BOLLENBACK & FORRET, P.A. 401(K) RETIREMENT PLAN 2017 592134908 2018-09-29 BOLLENBACK & FORRET, P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433

Signature of
Role Plan administrator
Date 2018-09-29
Name of individual signing MICHAEL D. BOLLENBACK
Valid signature Filed with authorized/valid electronic signature
BOLLENBACK & FORRET, P.A. 401(K) RETIREMENT PLAN 2016 592134908 2017-07-19 BOLLENBACK & FORRET, P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing MICHAEL D. BOLLENBACK
Valid signature Filed with authorized/valid electronic signature
BOLLENBACK & FORRET, P.A. 401(K) RETIREMENT PLAN 2015 592134908 2016-06-09 BOLLENBACK & FORRET, P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433

Signature of
Role Plan administrator
Date 2016-06-09
Name of individual signing MICHAEL D. BOLLENBACK
Valid signature Filed with authorized/valid electronic signature
BOLLENBACK & FORRET, P.A. 401(K) RETIREMENT PLAN 2014 592134908 2015-06-08 BOLLENBACK & FORRET, P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-01-01
Business code 541211
Sponsor’s telephone number 7274465858
Plan sponsor’s address 1000 PINELLAS STREET, CLEARWATER, FL, 337563433

Signature of
Role Plan administrator
Date 2015-06-08
Name of individual signing MICHAEL D. BOLLENBACK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
PATRICK SUZANNE E Agent 1000 PINELLAS STREET, CLEARWATER, FL, 33756

Vice President

Name Role Address
BUSCHART RICHARD G Vice President 1000 PINELLAS STREET, CLEARWATER, FL, 33756

President

Name Role Address
PATRICK SUZANNE E President 1000 PINELLAS STREET, CLEARWATER, FL, 33756

Related by officers

PATRICK SUZANNE E

MARSU VENTURES LLC LEADERSHIP PINELLAS FOUNDATION, INC. MAR TECK INDUSTRIES, INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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