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  5. JEFFERSON R. VAUGHAN, M.D., P.A.

JEFFERSON R. VAUGHAN, M.D., P.A.

Company Details

Entity Name: JEFFERSON R. VAUGHAN, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 17 Jul 2007 (18 years ago)
Date of dissolution: 01 Nov 2012 (12 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 01 Nov 2012 (12 years ago)
Document Number: P07000081796
FEI/EIN Number 260596202
Address: 1002 SOUTH OLD DIXIE HIGHWAY, 203, JUPITER, FL, 33458
Mail Address: PO BOX 7532, JUPITER, FL, 33468
ZIP code: 33458
County: Palm Beach
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JEFFERSON R. VAUGHAN, M.D. 401(K) SAFE HARBOR PLAN 2012 260596202 2013-07-26 JEFFERSON R. VAUGHAN, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-11
Business code 621111
Sponsor’s telephone number 5615960200
Plan sponsor’s address P O BOX 7532, JUPITER, FL, 33468

Signature of
Role Plan administrator
Date 2013-07-26
Name of individual signing JEFFERSON VAUGHAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-26
Name of individual signing JEFFERSON VAUGHAN
Valid signature Filed with authorized/valid electronic signature
JEFFERSON R. VAUGHAN, M.D. 401(K) SAFE HARBOR PLAN 2011 260596202 2012-09-10 JEFFERSON R. VAUGHAN, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-11
Business code 621111
Sponsor’s telephone number 5615960200
Plan sponsor’s address P O BOX 7832, JUPITER, FL, 33468

Plan administrator’s name and address
Administrator’s EIN 260596202
Plan administrator’s name JEFFERSON R. VAUGHAN, M.D., P.A.
Plan administrator’s address P O BOX 7832, JUPITER, FL, 33468
Administrator’s telephone number 5615960200

Signature of
Role Plan administrator
Date 2012-09-10
Name of individual signing JEFFERSON VAUGHN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-10
Name of individual signing JEFFERSON VAUGHN
Valid signature Filed with authorized/valid electronic signature
JEFFERSON R. VAUGHAN, M.D. 401(K) SAFE HARBOR PLAN 2010 260596202 2011-09-21 JEFFERSON R. VAUGHAN, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-11
Business code 621111
Sponsor’s telephone number 5615960200
Plan sponsor’s address P O BOX 7832, JUPITER, FL, 33468

Plan administrator’s name and address
Administrator’s EIN 260596202
Plan administrator’s name JEFFERSON R. VAUGHAN, M.D., P.A.
Plan administrator’s address P O BOX 7832, JUPITER, FL, 33468
Administrator’s telephone number 5615960200

Signature of
Role Plan administrator
Date 2011-09-21
Name of individual signing JEFFERSON VAUGHN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-21
Name of individual signing JEFFERSON VAUGHN
Valid signature Filed with authorized/valid electronic signature
JEFFERSON R. VAUGHAN, M.D. 401(K) SAFE HARBOR PLAN 2009 260596202 2010-05-12 JEFFERSON R. VAUGHAN, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-04-11
Business code 621111
Sponsor’s telephone number 5615960200
Plan sponsor’s address P O BOX 7832, JUPITER, FL, 33468

Plan administrator’s name and address
Administrator’s EIN 260596202
Plan administrator’s name JEFFERSON R. VAUGHAN, M.D., P.A.
Plan administrator’s address P O BOX 7832, JUPITER, FL, 33468
Administrator’s telephone number 5615960200

Signature of
Role Plan administrator
Date 2010-05-12
Name of individual signing KAREN PICKERING
Valid signature Filed with authorized/valid electronic signature
JEFFERSON R. VAUGHAN, M.D. 401(K) SAFE HARBOR PLAN 2009 260596202 2010-05-12 JEFFERSON R. VAUGHAN, M.D., P.A. 2
Three-digit plan number (PN) 001
Effective date of plan 2006-04-11
Business code 621111
Sponsor’s telephone number 5615960200
Plan sponsor’s address P O BOX 7832, JUPITER, FL, 33468

Plan administrator’s name and address
Administrator’s EIN 260596202
Plan administrator’s name JEFFERSON R. VAUGHAN, M.D., P.A.
Plan administrator’s address P O BOX 7832, JUPITER, FL, 33468
Administrator’s telephone number 5615960200

Signature of
Role Plan administrator
Date 2010-05-12
Name of individual signing JEFFERSON VAUGHAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
VAUGHAN JEFFERSON R Agent 1002 SOUTH OLD DIXIE HIGHWAY, JUPITER, FL, 33458

President

Name Role Address
VAUGHAN JEFFERSON R President 1002 SOUTH OLD DIXIE HIGHWAY, STE 203, JUPITER, FL, 33458

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2012-11-01 No data No data
CHANGE OF PRINCIPAL ADDRESS 2008-01-21 1002 SOUTH OLD DIXIE HIGHWAY, 203, JUPITER, FL 33458 No data
REGISTERED AGENT ADDRESS CHANGED 2008-01-21 1002 SOUTH OLD DIXIE HIGHWAY, 203, JUPITER, FL 33458 No data
CHANGE OF MAILING ADDRESS 2007-10-11 1002 SOUTH OLD DIXIE HIGHWAY, 203, JUPITER, FL 33458 No data

Documents

Name Date
Voluntary Dissolution 2012-11-01
ANNUAL REPORT 2012-04-02
ANNUAL REPORT 2011-04-05
ANNUAL REPORT 2010-02-17
ANNUAL REPORT 2009-03-24
ANNUAL REPORT 2008-01-21
Domestic Profit 2007-07-17

Related by officers

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Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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