Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Hillsborough
    4. ›
  4. 33624
    5. ›
  5. SEIBERT INSURANCE AGENCY, INC.

SEIBERT INSURANCE AGENCY, INC.

Company Details

Entity Name: SEIBERT INSURANCE AGENCY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 05 Apr 2022 (3 years ago)
Document Number: P07000114172
FEI/EIN Number 261265841
Address: 5121 EHRLICH ROAD, SUITE 111, TAMPA, FL, 33624, US
Mail Address: 989 14th Avenue S, Safety Harbor, FL, 34695, US
ZIP code: 33624
County: Hillsborough
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2023 261265841 2024-07-26 SEIBERT INSURANCE AGENCY, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH RD, SUITE 111B, TAMPA, FL, 33624

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP , LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-07-26
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2022 261265841 2023-09-08 SEIBERT INSURANCE AGENCY, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH RD, SUITE 111B, TAMPA, FL, 33624

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP , LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-09-08
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2021 261265841 2022-07-20 SEIBERT INSURANCE AGENCY, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH RD, SUITE 111B, TAMPA, FL, 33624

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2022-07-20
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2020 261265841 2021-07-12 SEIBERT INSURANCE AGENCY, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH RD, SUITE 111B, TAMPA, FL, 33624

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2021-07-12
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2019 261265841 2020-10-14 SEIBERT INSURANCE AGENCY, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH ROAD, SUITE 111B, TAMPA, FL, 33624

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing CANDICE BRANTLEY
Valid signature Filed with authorized/valid electronic signature
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2018 261265841 2019-10-14 SEIBERT INSURANCE AGENCY, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH ROAD, SUITE 111B, TAMPA, FL, 33624

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing CANDICE BRANTLEY
Valid signature Filed with authorized/valid electronic signature
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2017 261265841 2018-09-26 SEIBERT INSURANCE AGENCY, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH ROAD, SUITE 111B, TAMPA, FL, 33624

Signature of
Role Plan administrator
Date 2018-09-26
Name of individual signing CANDICE BRANTLEY
Valid signature Filed with authorized/valid electronic signature
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2016 261265841 2017-10-13 SEIBERT INSURANCE AGENCY, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH ROAD, SUITE 111B, TAMPA, FL, 33624

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing CANDICE BRANTLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-13
Name of individual signing CANDICE BRANTLEY
Valid signature Filed with authorized/valid electronic signature
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2015 261265841 2016-10-13 SEIBERT INSURANCE AGENCY, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH ROAD, SUITE 111B, TAMPA, FL, 33624

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing KARYN S. ROELING
Valid signature Filed with authorized/valid electronic signature
SEIBERT INSURANCE AGENCY, INC. 401(K) PLAN 2014 261265841 2015-07-13 SEIBERT INSURANCE AGENCY, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-02-01
Business code 524210
Sponsor’s telephone number 8139604672
Plan sponsor’s address 5121 EHRLICH ROAD, SUITE 111B, TAMPA, FL, 33624

Signature of
Role Plan administrator
Date 2015-07-13
Name of individual signing KARYN S. ROELING
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ROELING KARYN Agent 989 14th Avenue S, Safety Harbor, FL, 34695

President

Name Role Address
ROELING KARYN President 989 14TH AVENUE S, SAFETY HARBOR, FL, 34695

Secretary

Name Role Address
ROELING KARYN Secretary 989 14TH AVENUE S, SAFETY HARBOR, FL, 34695

Director

Name Role Address
ROELING KARYN Director 989 14TH AVENUE S, SAFETY HARBOR, FL, 34695

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2023-01-21 5121 EHRLICH ROAD, SUITE 111, TAMPA, FL 33624 No data
REGISTERED AGENT ADDRESS CHANGED 2023-01-21 989 14th Avenue S, Safety Harbor, FL 34695 No data
REGISTERED AGENT NAME CHANGED 2013-01-24 ROELING, KARYN No data
CHANGE OF PRINCIPAL ADDRESS 2008-01-07 5121 EHRLICH ROAD, SUITE 111, TAMPA, FL 33624 No data

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-01-21
ANNUAL REPORT 2022-01-21
ANNUAL REPORT 2021-01-08
ANNUAL REPORT 2020-01-19
ANNUAL REPORT 2019-01-16
ANNUAL REPORT 2018-03-06
ANNUAL REPORT 2017-01-03
ANNUAL REPORT 2016-02-11
ANNUAL REPORT 2015-02-23

Related by officers

ROELING KARYN

AGENCY EXCELERATOR, LLC SEIBERT PROPERTIES, LLC

Related by address

5121 EHRLICH ROAD, SUITE 111, TAMPA, FL, 33624, US

SEIBERT PROPERTIES, LLC

Date of last update: 01 Feb 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated