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  5. COMPLETE BENEFIT SOLUTIONS, INC.

COMPLETE BENEFIT SOLUTIONS, INC.

Company Details

Entity Name: COMPLETE BENEFIT SOLUTIONS, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 27 Dec 2002 (22 years ago)
Document Number: P02000134554
FEI/EIN Number 300140123
Address: 1336 Hideaway Dr South, Saint Johns, FL, 32259, US
Mail Address: 1336 Hideaway Dr South, Saint Johns, FL, 32259, US
ZIP code: 32259
County: St. Johns
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COMPLETE BENEFIT SOLUTIONS, INC. 401(K) P/S PLAN 2013 300140123 2014-05-28 COMPLETE BENEFIT SOLUTIONS, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 524210
Sponsor’s telephone number 9047374165
Plan sponsor’s address 236 PONTE VEDRA PARK DR. #101, PONTE VEDRA BEACH, FL, 32082

Plan administrator’s name and address
Administrator’s EIN 300140123
Plan administrator’s name COMPLETE BENEFIT SOLUTIONS, INC.
Plan administrator’s address 236 PONTE VEDRA PARK DR. #101, PONTE VEDRA BEACH, FL, 32082
Administrator’s telephone number 9047374165

Signature of
Role Plan administrator
Date 2014-05-28
Name of individual signing ANNELIESE CLARK
Valid signature Filed with authorized/valid electronic signature
COMPLETE BENEFIT SOLUTIONS, INC. 401(K) P/S PLAN 2012 300140123 2013-07-16 COMPLETE BENEFIT SOLUTIONS, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 524210
Sponsor’s telephone number 9047374165
Plan sponsor’s address 12276 SAN JOSE BLVD. #529, JACKSONVILLE, FL, 32223

Plan administrator’s name and address
Administrator’s EIN 300140123
Plan administrator’s name COMPLETE BENEFIT SOLUTIONS, INC.
Plan administrator’s address 12276 SAN JOSE BLVD. #529, JACKSONVILLE, FL, 32223
Administrator’s telephone number 9047374165

Signature of
Role Plan administrator
Date 2013-07-16
Name of individual signing ANNELIESE CLARK
Valid signature Filed with authorized/valid electronic signature
COMPLETE BENEFIT SOLUTIONS, INC. 401(K) P/S PLAN 2011 300140123 2012-07-17 COMPLETE BENEFIT SOLUTIONS, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 524210
Sponsor’s telephone number 9047374165
Plan sponsor’s address 12276 SAN JOSE BLVD. #529, JACKSONVILLE, FL, 32223

Plan administrator’s name and address
Administrator’s EIN 300140123
Plan administrator’s name COMPLETE BENEFIT SOLUTIONS, INC.
Plan administrator’s address 12276 SAN JOSE BLVD. #529, JACKSONVILLE, FL, 32223
Administrator’s telephone number 9047374165

Signature of
Role Plan administrator
Date 2012-07-17
Name of individual signing ANNELIESE CLARK
Valid signature Filed with authorized/valid electronic signature
COMPLETE BENEFIT SOLUTIONS, INC. 401(K) P/S PLAN 2010 300140123 2011-03-18 COMPLETE BENEFIT SOLUTIONS, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 524210
Sponsor’s telephone number 9047374165
Plan sponsor’s address 12276 SAN JOSE BLVD. #529, JACKSONVILLE, FL, 32223

Plan administrator’s name and address
Administrator’s EIN 300140123
Plan administrator’s name COMPLETE BENEFIT SOLUTIONS, INC.
Plan administrator’s address 12276 SAN JOSE BLVD. #529, JACKSONVILLE, FL, 32223
Administrator’s telephone number 9047374165

Signature of
Role Plan administrator
Date 2011-03-18
Name of individual signing ANNELIESE CLARK
Valid signature Filed with authorized/valid electronic signature
COMPLETE BENEFIT SOLUTIONS, INC. 401(K) P/S PLAN 2009 300140123 2010-06-24 COMPLETE BENEFIT SOLUTIONS, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 524210
Sponsor’s telephone number 9047374165
Plan sponsor’s address 12276 SAN JOSE BLVD. #529, JACKSONVILLE, FL, 32223

Plan administrator’s name and address
Administrator’s EIN 300140123
Plan administrator’s name COMPLETE BENEFIT SOLUTIONS, INC.
Plan administrator’s address 12276 SAN JOSE BLVD. #529, JACKSONVILLE, FL, 32223
Administrator’s telephone number 9047374165

Signature of
Role Plan administrator
Date 2010-06-24
Name of individual signing NOEL CLARK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CLARK ANNELIESE Agent 1336 HIDEAWAY DR S, JACKSONVILLE, FL, 32259

President

Name Role Address
CLARK ANNELIESE President 1336 HIDEAWAY DR S, JACKSONVILLE, FL, 32259

Vice President

Name Role Address
Weathington Ricky J Vice President 1336 Hideaway Dr South, Saint Johns, FL, 32259

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2015-04-06 1336 Hideaway Dr South, Saint Johns, FL 32259 No data
CHANGE OF MAILING ADDRESS 2015-04-06 1336 Hideaway Dr South, Saint Johns, FL 32259 No data
REGISTERED AGENT ADDRESS CHANGED 2006-07-05 1336 HIDEAWAY DR S, JACKSONVILLE, FL 32259 No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J15000059283 TERMINATED 1000000648446 ST JOHNS 2014-12-08 2025-01-08 $ 3,690.99 STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825
J12000902331 TERMINATED 1000000406758 DUVAL 2012-11-19 2022-11-28 $ 879.65 STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825

Documents

Name Date
ANNUAL REPORT 2024-03-16
ANNUAL REPORT 2023-04-08
ANNUAL REPORT 2022-03-07
ANNUAL REPORT 2021-07-27
ANNUAL REPORT 2020-03-24
ANNUAL REPORT 2019-04-16
ANNUAL REPORT 2018-03-06
ANNUAL REPORT 2017-03-20
ANNUAL REPORT 2016-04-15
ANNUAL REPORT 2015-04-06

Related by officers

CLARK ANNELIESE

GREEN ENERGY ENTERPRISES, INC. BIOBLOOM, LLC FIRST COAST AUTO SOLUTIONS, INC. FIRST COAST PROPERTY PRESERVATION INC. CLARK ESTATE, LLC

Weathington Ricky J

FIRST COAST AUTO SOLUTIONS, INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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