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  5. HEADLEY INSURANCE AGENCY, LLC

HEADLEY INSURANCE AGENCY, LLC - Florida Company Profile

Company Details

Entity Name: HEADLEY INSURANCE AGENCY, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

HEADLEY INSURANCE AGENCY, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
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: 21 Jan 2005 (20 years ago)
Last Event: AMENDMENT
Event Date Filed: 11 Apr 2005 (20 years ago)
Document Number: L05000006726
FEI/EIN Number 202214257

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 3544 S. FLORIDA AVENUE, LAKELAND, FL, 33803
Mail Address: 3544 S. FLORIDA AVENUE, LAKELAND, FL, 33803
ZIP code: 33803
County: Polk
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HEADLEY INSURANCE AGENCY LLC 401(K) PROFIT SHARING PLAN & TRUST 2023 202214257 2024-04-17 HEADLEY INSURANCE AGENCY LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2024-04-17
Name of individual signing HEADLEYJANELL1
Valid signature Filed with authorized/valid electronic signature
HEADLEY INSURANCE AGENCY LLC 401(K) PROFIT SHARING PLAN & TRUST 2022 202214257 2023-04-03 HEADLEY INSURANCE AGENCY LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2023-04-03
Name of individual signing SCOTT HEADLEY
Valid signature Filed with authorized/valid electronic signature
HEADLEY INSURANCE AGENCY LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 202214257 2022-03-30 HEADLEY INSURANCE AGENCY LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2022-03-30
Name of individual signing SCOTT J HEADLEY
Valid signature Filed with authorized/valid electronic signature
HEADLEY INSURANCE AGENCY LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 202214257 2021-04-01 HEADLEY INSURANCE AGENCY LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2021-04-01
Name of individual signing SCOTT HEADLEY
Valid signature Filed with authorized/valid electronic signature
HEADLEY INSURANCE AGENCY LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 202214257 2020-04-08 HEADLEY INSURANCE AGENCY LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2020-04-08
Name of individual signing SCOTT JOSEPH HEADLEY
Valid signature Filed with authorized/valid electronic signature
HEADLEY INSURANCE AGENCY LLC 401 K PROFIT SHARING PLAN TRUST 2018 202214257 2019-07-12 HEADLEY INSURANCE AGENCY LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2019-07-12
Name of individual signing SCOTT J HEADLEY
Valid signature Filed with authorized/valid electronic signature
HEADLEY INSURANCE AGENCY LLC 401 K PROFIT SHARING PLAN TRUST 2017 202214257 2018-04-06 HEADLEY INSURANCE AGENCY LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2018-04-06
Name of individual signing SCOTT HEADLEY
Valid signature Filed with authorized/valid electronic signature
HEADLEY INSURANCE AGENCY LLC 401 K PROFIT SHARING PLAN TRUST 2016 202214257 2017-07-28 HEADLEY INSURANCE AGENCY LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2017-07-28
Name of individual signing SCOTT HEADLEY
Valid signature Filed with authorized/valid electronic signature
HEADLEY INSURANCE AGENCY LLC 401 K PROFIT SHARING PLAN TRUST 2015 202214257 2016-07-14 HEADLEY INSURANCE AGENCY LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2016-07-14
Name of individual signing SCOTT HEADLEY
Valid signature Filed with authorized/valid electronic signature
HEADLEY INSURANCE AGENCY LLC 401 K PROFIT SHARING PLAN TRUST 2014 202214257 2015-05-26 HEADLEY INSURANCE AGENCY LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 524210
Sponsor’s telephone number 8637017411
Plan sponsor’s address 3544 S FLORIDA AVE, LAKELAND, FL, 338034866

Signature of
Role Plan administrator
Date 2015-05-26
Name of individual signing SCOTT HEADLEY
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
HEADLEY SCOTT J Managing Member 3544 S. FLORIDA AVENUE, LAKELAND, FL, 33803
HEADLEY SHARI J Managing Member 3544 S. FLORIDA AVENUE, LAKELAND, FL, 33803
HEADLEY SCOTT J Agent 3544 S. FLORIDA AVENUE, LAKELAND, FL, 33803

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2020-01-16 HEADLEY, SCOTT J -
AMENDMENT 2005-04-11 - -

Documents

Name Date
ANNUAL REPORT 2024-02-09
ANNUAL REPORT 2023-01-27
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-04-06
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-04-03
ANNUAL REPORT 2018-06-27
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-01-22
ANNUAL REPORT 2015-01-08

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8153657009 2020-04-08 0455 PPP 3544 South Florida Ave, LAKELAND, FL, 33803-4866
Loan Status Date 2021-03-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 99800
Loan Approval Amount (current) 99800
Undisbursed Amount 0
Franchise Name -
Lender Location ID 453559
Servicing Lender Name Prime Meridian Bank
Servicing Lender Address 1471 Timberlane Rd, TALLAHASSEE, FL, 32308-4598
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address LAKELAND, POLK, FL, 33803-4866
Project Congressional District FL-18
Number of Employees 11
NAICS code 524210
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 453559
Originating Lender Name Prime Meridian Bank
Originating Lender Address TALLAHASSEE, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 100658.55
Forgiveness Paid Date 2021-02-25

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HEADLEY SHARI J

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Date of last update: 02 Apr 2025

Sources: Florida Department of State

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