| Entity Name: | JEFFERSONVILLE ADULT HOME, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 25 Jun 2008 (17 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | L08000062171 |
| Address: | 17636 ORANGE BLVD, LOXAHATCHEE, 33470, FL |
| Mail Address: | 17636 ORANGE BLVD, LOXAHATCHEE, 33470, FL |
| ZIP code: | 33470 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFERSONVILLE ADULT HOME 401(K) PROFIT SHARING PLAN & TRUST | 2009 | 141722157 | 2010-11-11 | JEFFERSONVILLE ADULT HOME | 0 | |||||||||||||||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 141722157 |
| Plan administrator’s name | JEFFERSONVILLE ADULT HOME |
| Plan administrator’s address | C/O PERSAUD 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
| Administrator’s telephone number | 5617848286 |
Number of participants as of the end of the plan year
| Active participants | 0 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 16 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2010-11-11 |
| Name of individual signing | LEONARD PERSAUD |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2001-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 5617848286 |
| Plan sponsor’s mailing address | C/O PERSAUD 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
| Plan sponsor’s address | C/O PERSAUD 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
Plan administrator’s name and address
| Administrator’s EIN | 141722157 |
| Plan administrator’s name | JEFFERSONVILLE ADULT HOME |
| Plan administrator’s address | C/O PERSAUD 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
| Administrator’s telephone number | 5617848286 |
Number of participants as of the end of the plan year
| Active participants | 15 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 9 |
| Number of participants with account balances as of the end of the plan year | 16 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2010-11-10 |
| Name of individual signing | LEONARD PERSAUD |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2001-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 5617848286 |
| Plan sponsor’s mailing address | C/O PERSAUD 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
| Plan sponsor’s address | C/O PERSAUD 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
Plan administrator’s name and address
| Administrator’s EIN | 141722157 |
| Plan administrator’s name | JEFFERSONVILLE ADULT HOME |
| Plan administrator’s address | C/O PERSAUD 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
| Administrator’s telephone number | 5617848286 |
Number of participants as of the end of the plan year
| Active participants | 12 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 2 |
| Number of participants with account balances as of the end of the plan year | 5 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2010-11-10 |
| Name of individual signing | LEONARD PERSAUD |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| PERSAUD LEONARD H | Agent | 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
| Name | Role | Address |
|---|---|---|
| PERSAUD HELEN S | Manager | 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
| PERSAUD LOENARD H | Manager | 17636 ORANGE BLVD, LOXAHATCHEE, FL, 33470 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2008-06-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
