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  5. BRAIN INJURY ASSOCIATION OF FLORIDA, INC.

BRAIN INJURY ASSOCIATION OF FLORIDA, INC.

Company Details

Entity Name: BRAIN INJURY ASSOCIATION OF FLORIDA, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 26 Sep 1985 (39 years ago)
Document Number: N11295
FEI/EIN Number 592611863
Address: 111 N Lakemont Ave., WINTER PARK, FL, 32792, US
Mail Address: P.O. Box 1182, Winter Park, FL, 32790, US
ZIP code: 32792
County: Orange
Place of Formation: FLORIDA

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
630V1 Active Non-Manufacturer 2010-07-30 2023-06-23 No data No data

Contact Information
POC DJENABA A. BURNS
Phone +1 850-410-0103
Fax +1 850-410-0105
Address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308 3946, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA INC 2017 592611863 2018-07-26 BRAIN INJURY ASSOCIATION OF FLORIDA INC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 323083946

Signature of
Role Plan administrator
Date 2018-07-26
Name of individual signing DJENABA A BURNS
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA, INC. 2016 592611863 2017-07-25 BRAIN INJURY ASSOCIATION OF FLORIDA , INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2017-07-25
Name of individual signing DJENABA BURNS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-25
Name of individual signing DJENABA BURNS
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA, INC. 2015 592611863 2016-08-30 BRAIN INJURY ASSOCIATION OF FLORIDA , INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2016-08-30
Name of individual signing DJENABA BURNS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-30
Name of individual signing DJENABA BURNS
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA, INC. 2014 592611863 2015-08-27 BRAIN INJURY ASSOCIATION OF FLORIDA , INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2015-08-27
Name of individual signing DJENABA BURNS
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA, INC. 2013 592611863 2014-07-21 BRAIN INJURY ASSOCIATION OF FLORIDA , INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2014-07-21
Name of individual signing DJENABA BURNS
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA, INC. 2012 592611863 2013-07-15 BRAIN INJURY ASSOCIATION OF FLORIDA , INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2013-07-15
Name of individual signing DJENABA BURNS
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA, INC. 2011 592611863 2012-05-01 BRAIN INJURY ASSOCIATION OF FLORIDA , INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308

Plan administrator’s name and address
Administrator’s EIN 592611863
Plan administrator’s name BRAIN INJURY ASSOCIATION OF FLORIDA , INC.
Plan administrator’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308
Administrator’s telephone number 8504100103

Signature of
Role Plan administrator
Date 2012-05-01
Name of individual signing JUDITH MADSEN
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA, INC. 2010 592611863 2011-07-07 BRAIN INJURY ASSOCIATION OF FLORIDA , INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308

Plan administrator’s name and address
Administrator’s EIN 592611863
Plan administrator’s name BRAIN INJURY ASSOCIATION OF FLORIDA , INC.
Plan administrator’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308
Administrator’s telephone number 8504100103

Signature of
Role Plan administrator
Date 2011-07-07
Name of individual signing JUDITH MADSEN
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA, INC. 2009 592611863 2010-07-28 BRAIN INJURY ASSOCIATION OF FLORIDA , INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308

Plan administrator’s name and address
Administrator’s EIN 592611863
Plan administrator’s name BRAIN INJURY ASSOCIATION OF FLORIDA , INC.
Plan administrator’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308
Administrator’s telephone number 8504100103

Signature of
Role Plan administrator
Date 2010-07-14
Name of individual signing JUDITH MADSEN
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF BRAIN INJURY ASSOCIATION OF FLORIDA, INC. 2009 592611863 2010-07-19 BRAIN INJURY ASSOCIATION OF FLORIDA , INC. 10
Three-digit plan number (PN) 001
Effective date of plan 1996-03-01
Business code 624100
Sponsor’s telephone number 8504100103
Plan sponsor’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308

Plan administrator’s name and address
Administrator’s EIN 592611863
Plan administrator’s name BRAIN INJURY ASSOCIATION OF FLORIDA , INC.
Plan administrator’s address 1637 METROPOLITAN BLVD STE B, TALLAHASSEE, FL, 32308
Administrator’s telephone number 8504100103

Signature of
Role Plan administrator
Date 2010-07-14
Name of individual signing JUDITH MADSEN
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Address
Jallad Johnny Agent 111 N Lakemont Ave., Winter Park, FL, 32792

Chairman

Name Role Address
BECK MICHAEL Chairman P.O. Box 1182, Winter Park, FL, 32790

Secretary

Name Role Address
CAUFFIELD CHRISTINE Secretary P.O. Box 1182, Winter Park, FL, 32790

Events

Event Type Filed Date Value Description
REINSTATEMENT 2019-10-31 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 No data No data
NAME CHANGE AMENDMENT 1995-12-27 BRAIN INJURY ASSOCIATION OF FLORIDA, INC. No data
NAME CHANGE AMENDMENT 1993-11-22 FLORIDA HEAD INJURY ASSOCIATION, INC. No data
AMENDMENT 1986-05-29 No data No data

Related by officers

BECK MICHAEL

BECKTECH PRECISION INC BECK TRUCKING COMPANY LLC FLORIDA OUTDOOR CENTER INC LUNCH LADY, INC. SYNERGY CORPORATE TECHNOLOGY LTD, INC. CROESUS CORPORATE FINANCE, LLC DS PARTNERS LLC CONDOMINIUM ASSOCIATION OF THE VILLAGE, INC. A-1 SCREEN AND GLASS CO. COLONY COVE OWNERS ASSOCIATION OF SEMINOLE COUNTY, INC.

CAUFFIELD CHRISTINE

ANCHOR BEHAVIORAL HEALTH, LLC FLORIDA SUBSTANCE ABUSE CONSORTIUM, INC.

Jallad Johnny

UNITED SAFETY COUNCIL, INC.

Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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