| Entity Name: | T. LEROY JEFFERSON MEDICAL SOCIETY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 05 Dec 2001 (23 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 28 Jan 2008 (17 years ago) |
| Document Number: | N01000008500 |
| FEI/EIN Number | 331007795 |
| Address: | 2635 Old Okeechobee Road, West Palm Beach, FL, 33409, US |
| Mail Address: | 2635 Old Okeechobee Road, West Palm Beach, FL, 33409, US |
| ZIP code: | 33409 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| T. LEROY JEFFERSON MEDICAL SOCIETY 403(B) RETIREMENT PLAN | 2023 | 331007795 | 2024-06-26 | T. LEROY JEFFERSON MEDICAL SOCIETY INC | 2 | |||||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2024-06-26 |
| Name of individual signing | LAUREL DALTON |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-06-26 |
| Name of individual signing | LAUREL DALTON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 813000 |
| Sponsor’s telephone number | 5613180814 |
| Plan sponsor’s address | 4601 N CONGRESS AVE, STE 101, WEST PALM BEACH, FL, 33407 |
Signature of
| Role | Plan administrator |
| Date | 2023-04-17 |
| Name of individual signing | LAUREL DALTON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Dalton Laurel | Agent | 2635 Old Okeechobee Road, West Palm Beach, FL, 33409 |
| Name | Role | Address |
|---|---|---|
| Kiminyo Kitonga Dr. | Vice President | 2635 Old Okeechobee Road, West Palm Beach, FL, 33409 |
| Name | Role | Address |
|---|---|---|
| Taylor Arlene Dr. | Treasurer | 4371 Northlake Blvd, Palm Beach Gardens, FL, 33410 |
| Name | Role | Address |
|---|---|---|
| Lowe Catherine Dr. | Secretary | 2635 Old Okeechobee Road, West Palm Beach, FL, 33409 |
| Name | Role | Address |
|---|---|---|
| Bentsi-Enchill Flora Dr. | Chap | 2635 Old Okeechobee Road, West Palm Beach, FL, 33409 |
| Name | Role | Address |
|---|---|---|
| Smith Michael Dr. | Parl | 2635 Old Okeechobee Road, West Palm Beach, FL, 33409 |
| Name | Role | Address |
|---|---|---|
| Coleman Brian Dr. | President | 2635 Old Okeechobee Road, West Palm Beach, FL, 33409 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-13 | 2635 Old Okeechobee Road, West Palm Beach, FL 33409 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-13 | 2635 Old Okeechobee Road, West Palm Beach, FL 33409 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-13 | 2635 Old Okeechobee Road, West Palm Beach, FL 33409 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-25 | Dalton, Laurel | No data |
| CANCEL ADM DISS/REV | 2008-01-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-13 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-17 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-04-08 |
| AMENDED ANNUAL REPORT | 2018-09-24 |
| ANNUAL REPORT | 2018-03-07 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-03-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
