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  5. IMPACT FLORIDA, INC.

IMPACT FLORIDA, INC.

Company Details

Entity Name: IMPACT FLORIDA, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 24 Sep 2019 (5 years ago)
Document Number: N19000010130
FEI/EIN Number 61-1949614
Address: 3535 Riverside Ave, Jacksonville, FL, 32205, US
Mail Address: 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301, US
ZIP code: 32205
County: Duval
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
IMPACT FLORIDA, INC. 401(K) PLAN 2023 611949614 2024-05-14 IMPACT FLORIDA, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 813000
Sponsor’s telephone number 4152154994
Plan sponsor’s address 113 S MONROE ST, FIRST FLOOR, TALLAHASSEE, FL, 32301

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-05-14
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
IMPACT FLORIDA, INC. 401(K) PLAN 2022 611949614 2023-05-27 IMPACT FLORIDA, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 813000
Sponsor’s telephone number 4152154994
Plan sponsor’s address 113 S MONROE ST, FIRST FLOOR, TALLAHASSEE, FL, 32301

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2023-05-27
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
IMPACT FLORIDA, INC. 401(K) PLAN 2021 611949614 2022-05-19 IMPACT FLORIDA, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 813000
Sponsor’s telephone number 4152154994
Plan sponsor’s address 113 S MONROE ST, FIRST FLOOR, TALLAHASSEE, FL, 32301

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-05-19
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
IMPACT FLORIDA, INC. 401(K) PLAN 2020 611949614 2021-04-29 IMPACT FLORIDA, INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 813000
Sponsor’s telephone number 4152154994
Plan sponsor’s address 113 S MONROE ST, FIRST FLOOR, TALLAHASSEE, FL, 32301

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-04-29
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CLARK AMANDA Agent 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301

Director

Name Role Address
BROWNING KURT Director 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301
STEWART PAMELA Director 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301
JACKSON BENJAMAN Director 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301
Daniels Shanna Director 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301
Symonette Precious Dr. Director 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301

Treasurer

Name Role Address
JACKSON BENJAMAN Treasurer 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301

Secretary

Name Role Address
CLARK AMANDA Secretary 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301

President

Name Role Address
BROWNING KURT President 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL, 32301

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-07-12 3535 Riverside Ave, Jacksonville, FL 32205 No data
CHANGE OF MAILING ADDRESS 2022-01-20 3535 Riverside Ave, Jacksonville, FL 32205 No data
REGISTERED AGENT ADDRESS CHANGED 2022-01-20 113 SOUTH MONROE STREET, 1ST FLOOR, TALLAHASSEE, FL 32301 No data

Documents

Name Date
ANNUAL REPORT 2025-01-10
ANNUAL REPORT 2024-01-05
AMENDED ANNUAL REPORT 2023-07-12
ANNUAL REPORT 2023-01-26
ANNUAL REPORT 2022-01-20
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-06-01
Domestic Non-Profit 2019-09-24

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CLARK AMANDA

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Date of last update: 01 Feb 2025

Sources: Florida Department of State

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