| Entity Name: | REGENESIS HEALTH SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Sep 2002 (22 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P02000098239 |
| FEI/EIN Number | 743060998 |
| Address: | 10752 DEERWOOD PARK BLVD, JACKSONVILLE, FL, 32256, US |
| Mail Address: | 10752 DEERWOOD PARK BLVD, JACKSONVILLE, FL, 32256, US |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| REGENESIS HEALTH SERVICES INC 401 K PROFIT SHARING PLAN TRUST | 2015 | 743060998 | 2016-06-28 | REGENESIS HEALTH SERVICES INC | 17 | |||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2016-06-28 |
| Name of individual signing | SHAWN ANDERSEN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 9047839363 |
| Plan sponsor’s address | 1704 SOUTHSIDE BLVD STE 2, JACKSONVILLE, FL, 32216 |
Signature of
| Role | Plan administrator |
| Date | 2015-07-07 |
| Name of individual signing | SHAWN ANDERSEN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 9047839363 |
| Plan sponsor’s address | 1704 SOUTHSIDE BLVD, SUITE 2, JACKSONVILLE, FL, 32216 |
Signature of
| Role | Plan administrator |
| Date | 2014-07-17 |
| Name of individual signing | SHAWN ANDERSEN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BLOSSER JOHN M | Agent | 10752 Deerwood Park Blvd, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| BLOSSER JOHN M | President | 10752 DEERWOOD PARK BLVD, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| ANDERSEN SHAWN P | Vice President | 10752 DEERWOOD PARK BLVD, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| ANDERSEN SHAWN P | Treasurer | 10752 DEERWOOD PARK BLVD, JACKSONVILLE, FL, 32256 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-04-01 | 10752 Deerwood Park Blvd, 100, JACKSONVILLE, FL 32256 | No data |
| CHANGE OF MAILING ADDRESS | 2018-09-26 | 10752 DEERWOOD PARK BLVD, SUITE 100, JACKSONVILLE, FL 32256 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-09-26 | 10752 DEERWOOD PARK BLVD, SUITE 100, JACKSONVILLE, FL 32256 | No data |
| AMENDMENT | 2015-12-07 | No data | No data |
| AMENDMENT | 2014-03-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-03-27 | BLOSSER, JOHN M | No data |
| AMENDMENT | 2014-01-14 | No data | No data |
| REINSTATEMENT | 2013-11-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000198935 | ACTIVE | 23000050CA | CIRCUIT 20TH CHARLOTTE COUNTY | 2024-04-08 | 2029-04-09 | $478,361.93 | FIRST HORIZON BANK, 2000 INTERNATIONAL PARK DRIVE, BIRMINGHAM, AL 35243 |
| J14000703222 | TERMINATED | 1000000631029 | DUVAL | 2014-05-23 | 2034-05-29 | $ 2,649.31 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-04-01 |
| ANNUAL REPORT | 2019-07-03 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-05-10 |
| ANNUAL REPORT | 2016-01-26 |
| Amendment | 2015-12-07 |
| ANNUAL REPORT | 2015-01-07 |
| Amendment | 2014-03-27 |
| ANNUAL REPORT | 2014-01-15 |
| Amendment | 2014-01-14 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
