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TERRY L. CARLSON, P.A.

Company Details

Entity Name: TERRY L. CARLSON, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 02 Feb 2004 (21 years ago)
Document Number: P04000025251
FEI/EIN Number 200706666
Address: 730 SW 4TH ST, CAPE CORAL, FL, 33991, US
Mail Address: 1428 NW 25th Pl, CAPE CORAL, FL, 33993, US
ZIP code: 33991
County: Lee
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TERRY L. CARLSON, P.A. 401(K) PLAN 2023 200706666 2024-07-17 TERRY L. CARLSON, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-10-01
Business code 531210
Sponsor’s telephone number 2397706955
Plan sponsor’s address 1428 NW 25TH PL., CAPE CORAL, FL, 33993

Signature of

Role Plan administrator
Date 2024-07-17
Name of individual signing TERRY L CARLSON
Valid signature Filed with authorized/valid electronic signature
TERRY L. CARLSON, P.A. 401(K) PLAN 2022 200706666 2023-05-11 TERRY L. CARLSON, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-10-01
Business code 531210
Sponsor’s telephone number 2397706955
Plan sponsor’s address 1428 NW 25TH PL., CAPE CORAL, FL, 33993

Signature of

Role Plan administrator
Date 2023-05-11
Name of individual signing TERRY L CARLSON
Valid signature Filed with authorized/valid electronic signature
TERRY L. CARLSON, P.A. 401(K) PLAN 2021 200706666 2022-07-15 TERRY L. CARLSON, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-10-01
Business code 531210
Sponsor’s telephone number 2395428611
Plan sponsor’s address 3208 CHIQUITA BLVD S., #204, CAPE CORAL, FL, 33914

Signature of

Role Plan administrator
Date 2022-07-15
Name of individual signing TERRY L CARLSON
Valid signature Filed with authorized/valid electronic signature
TERRY L. CARLSON, P.A. 401(K) PLAN 2020 200706666 2021-04-28 TERRY L. CARLSON, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-10-01
Business code 531210
Sponsor’s telephone number 2395428611
Plan sponsor’s address 3208 CHIQUITA BLVD S., #204, CAPE CORAL, FL, 33914

Signature of

Role Plan administrator
Date 2021-04-28
Name of individual signing TERRY L CARLSON
Valid signature Filed with authorized/valid electronic signature
TERRY L. CARLSON, P.A. 401(K) PLAN 2019 200706666 2020-06-01 TERRY L. CARLSON, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-10-01
Business code 531210
Sponsor’s telephone number 2395428611
Plan sponsor’s address 3208 CHIQUITA BLVD S., #204, CAPE CORAL, FL, 33914

Signature of

Role Plan administrator
Date 2020-06-01
Name of individual signing TERRY L CARLSON
Valid signature Filed with authorized/valid electronic signature
TERRY L. CARLSON, P.A. 401(K) PLAN 2018 200706666 2019-06-19 TERRY L. CARLSON, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-10-01
Business code 531210
Sponsor’s telephone number 2395428611
Plan sponsor’s address 3208 CHIQUITA BLVD S., #204, CAPE CORAL, FL, 33914

Signature of

Role Plan administrator
Date 2019-06-19
Name of individual signing TERRY L CARLSON
Valid signature Filed with authorized/valid electronic signature
TERRY L. CARLSON, P.A. 401(K) PLAN 2017 200706666 2018-06-29 TERRY L. CARLSON, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-10-01
Business code 531210
Sponsor’s telephone number 2395428611
Plan sponsor’s address 725 CAPE CORAL PKWY W., CAPE CORAL, FL, 33914

Signature of

Role Plan administrator
Date 2018-06-29
Name of individual signing TERRY L CARLSON
Valid signature Filed with authorized/valid electronic signature
TERRY L. CARLSON, P.A. 401(K) PLAN 2016 200706666 2017-10-02 TERRY L. CARLSON, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-10-01
Business code 531210
Sponsor’s telephone number 2395428611
Plan sponsor’s address 725 CAPE CORAL PKWY W., CAPE CORAL, FL, 33914

Signature of

Role Plan administrator
Date 2017-10-02
Name of individual signing TERRY L CARLSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CARLSON TERRY L Agent 1428 NW 25th Pl, CAPE CORAL, FL, 33993

President

Name Role Address
CARLSON TERRY L President 1428 NW 25th Pl, CAPE CORAL, FL, 33993

Secretary

Name Role Address
CARLSON TERRY L Secretary 1428 NW 25th Pl, CAPE CORAL, FL, 33993

Vice President

Name Role Address
Carlson Laurie A Vice President 1428 NW 25th Pl, CAPE CORAL, FL, 33993

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-07-26 730 SW 4TH ST, SUITE #2, CAPE CORAL, FL 33991 No data
CHANGE OF MAILING ADDRESS 2019-04-09 730 SW 4TH ST, SUITE #2, CAPE CORAL, FL 33991 No data
REGISTERED AGENT ADDRESS CHANGED 2019-04-09 1428 NW 25th Pl, CAPE CORAL, FL 33993 No data

Documents

Name Date
ANNUAL REPORT 2024-01-18
ANNUAL REPORT 2023-01-18
ANNUAL REPORT 2022-04-10
ANNUAL REPORT 2021-03-15
ANNUAL REPORT 2020-03-20
ANNUAL REPORT 2019-04-09
ANNUAL REPORT 2018-03-22
ANNUAL REPORT 2017-01-12
ANNUAL REPORT 2016-01-15
ANNUAL REPORT 2015-01-19

Date of last update: 01 Feb 2025

Sources: Florida Department of State