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  5. SHANE SWAN INSURANCE AGENCY, INC.

SHANE SWAN INSURANCE AGENCY, INC.

Company Details

Entity Name: SHANE SWAN INSURANCE AGENCY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 08 Dec 2005 (19 years ago)
Document Number: P05000161457
FEI/EIN Number 204166493
Address: 14416 Shoreside Way, Winter Garden, FL, 34787, US
Mail Address: 14416 Shoreside Way, Winter Garden, FL, 34787, US
ZIP code: 34787
County: Orange
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SHANE SWAN INSURANCE AGENCY, INC 401(K) PLAN 2019 204166493 2020-10-15 SHANE SWAN INSURANCE AGENCY, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524210
Sponsor’s telephone number 4078469333
Plan sponsor’s address 100 N. JOHN YOUNG PKWY, STE B, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-15
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
SHANE SWAN INSURANCE AGENCY, INC 401(K) PLAN 2018 204166493 2019-08-26 SHANE SWAN INSURANCE AGENCY, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524210
Sponsor’s telephone number 4078469333
Plan sponsor’s address 100 N. JOHN YOUNG PKWY, STE B, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2019-08-26
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-26
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
SHANE SWAN INSURANCE AGENCY, INC 401(K) PLAN 2017 204166493 2018-09-18 SHANE SWAN INSURANCE AGENCY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524210
Sponsor’s telephone number 4078469333
Plan sponsor’s address 100 N. JOHN YOUNG PKWY, STE B, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2018-09-18
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
SHANE SWAN INSURANCE AGENCY, INC 401(K) PLAN 2016 204166493 2017-10-10 SHANE SWAN INSURANCE AGENCY, INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524210
Sponsor’s telephone number 4078469333
Plan sponsor’s address 100 N. JOHN YOUNG PKWY, STE B, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2017-10-10
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
SHANE SWAN INSURANCE AGENCY, INC 401(K) PLAN 2015 204166493 2016-08-09 SHANE SWAN INSURANCE AGENCY, INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524210
Sponsor’s telephone number 4078469333
Plan sponsor’s address 100 N. JOHN YOUNG PKWY, STE B, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2016-08-09
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-09
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
SHANE SWAN INSURANCE AGENCY, INC. 401(K) PLAN 2014 204166493 2015-05-05 SHANE SWAN INSURANCE AGENCY, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524210
Sponsor’s telephone number 4078469333
Plan sponsor’s address 100 N. JOHN YOUNG PKWY. STE. B, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2015-05-05
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-05-05
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
SHANE SWAN INSURANCE AGENCY, INC. 401(K) PLAN 2013 204166493 2014-07-03 SHANE SWAN INSURANCE AGENCY, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 524210
Sponsor’s telephone number 4078469333
Plan sponsor’s address 100 N. JOHN YOUNG PKWY. STE. B, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2014-07-03
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-03
Name of individual signing SHANE SWAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SWAN SHANE Agent 14416 Shoreside Way, Winter Garden, FL, 34787

Director

Name Role Address
SWAN SHANE Director 14416 Shoreside Way, Winter Garden, FL, 34787

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G18000047082 STATE FARM AGENT EXPIRED 2018-04-12 2023-12-31 No data 100 N JOHN YOUNG PARKWAY, #B, KISSIMMEE, FL, 34741

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2019-03-05 14416 Shoreside Way, Suite 140, Winter Garden, FL 34787 No data
CHANGE OF MAILING ADDRESS 2019-03-05 14416 Shoreside Way, Suite 140, Winter Garden, FL 34787 No data
REGISTERED AGENT ADDRESS CHANGED 2019-03-05 14416 Shoreside Way, Suite 140, Winter Garden, FL 34787 No data

Documents

Name Date
ANNUAL REPORT 2024-02-27
ANNUAL REPORT 2023-06-06
ANNUAL REPORT 2022-04-18
ANNUAL REPORT 2021-03-17
ANNUAL REPORT 2020-07-29
ANNUAL REPORT 2019-03-05
ANNUAL REPORT 2018-06-07
ANNUAL REPORT 2017-05-01
ANNUAL REPORT 2016-02-23
ANNUAL REPORT 2015-04-22

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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