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  5. BLAKE THOMAS INSURANCE, INC.

BLAKE THOMAS INSURANCE, INC.

Company Details

Entity Name: BLAKE THOMAS INSURANCE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 14 Mar 2013 (12 years ago)
Date of dissolution: 22 Sep 2017 (7 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 22 Sep 2017 (7 years ago)
Document Number: P13000024119
FEI/EIN Number 46-2272268
Address: 5889 S WILLIAMSON BLVD, SUITE 220, PORT ORANGE, FL, 32128
Mail Address: 5889 S WILLIAMSON BLVD, SUITE 220, PORT ORANGE, FL, 32128
ZIP code: 32128
County: Volusia
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLAKE THOMAS INSURANCE 401(K) PLAN 2023 593034420 2024-06-07 BLAKE THOMAS INSURANCE 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 4639 CLYDE MORRIS BLVD, #107, PORT ORANGE, FL, 32129

Signature of
Role Plan administrator
Date 2024-06-07
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
BLAKE THOMAS INSURANCE 401(K) PLAN 2022 593034420 2023-06-21 BLAKE THOMAS INSURANCE 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 5889 S. WILLIAMSON BLVD, #220, PORT ORANGE, FL, 32128

Signature of
Role Plan administrator
Date 2023-06-21
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
BLAKE THOMAS INSURANCE 401(K) PLAN 2021 593034420 2022-06-27 BLAKE THOMAS INSURANCE 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 5889 S. WILLIAMSON BLVD, #220, PORT ORANGE, FL, 32128

Signature of
Role Plan administrator
Date 2022-06-27
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
BLAKE THOMAS INSURANCE 401(K) PLAN 2020 593034420 2021-06-23 BLAKE THOMAS INSURANCE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 5889 S. WILLIAMSON BLVD, #220, PORT ORANGE, FL, 32128

Signature of
Role Plan administrator
Date 2021-06-23
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
BLAKE THOMAS INSURANCE 401(K) PLAN 2019 593034420 2020-09-03 BLAKE THOMAS INSURANCE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 5889 S. WILLIAMSON BLVD, #220, PORT ORANGE, FL, 32128

Signature of
Role Plan administrator
Date 2020-09-03
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
BLAKE THOMAS INSURANCE 401(K) PLAN 2018 593034420 2019-06-19 BLAKE THOMAS INSURANCE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 5889 S. WILLIAMSON BLVD, #220, PORT ORANGE, FL, 32128

Signature of
Role Plan administrator
Date 2019-06-19
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
BLAKE THOMAS INSURANCE 401(K) PLAN 2017 593034420 2018-06-25 BLAKE THOMAS INSURANCE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 5889 S. WILLIAMSON BLVD, #220, PORT ORANGE, FL, 32128

Signature of
Role Plan administrator
Date 2018-06-25
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
BLAKE THOMAS INSURANCE 401(K) PLAN 2016 593034420 2017-09-20 BLAKE THOMAS INSURANCE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 5889 S. WILLIAMSON BLVD, #220, PORT ORANGE, FL, 32128

Signature of
Role Plan administrator
Date 2017-09-20
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
BLAKE THOMAS INSURANCE 401(K) PLAN 2015 593034420 2016-08-16 BLAKE THOMAS INSURANCE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 5889 S. WILLIAMSON BLVD, #220, PORT ORANGE, FL, 32128

Signature of
Role Plan administrator
Date 2016-08-16
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-16
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
BLAKE THOMAS INSURANCE 401(K) PLAN 2014 593034420 2015-04-02 BLAKE THOMAS INSURANCE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 524210
Sponsor’s telephone number 3867602020
Plan sponsor’s address 5889 S. WILLIAMSON BLVD. #220, PORT ORANGE, FL, 32128

Signature of
Role Plan administrator
Date 2015-04-02
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-02
Name of individual signing BLAKE THOMAS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
THOMAS BLAKE Agent 5889 S WILLIAMSON BLVD, PORT ORANGE, FL, 32128

President

Name Role Address
THOMAS BLAKE President 5889 S WILLIAMSON BLVD, SUITE 220, PORT ORANGE, FL, 32128

Secretary

Name Role Address
THOMAS BLAKE Secretary 5889 S WILLIAMSON BLVD, SUITE 220, PORT ORANGE, FL, 32128

Treasurer

Name Role Address
THOMAS BLAKE Treasurer 5889 S WILLIAMSON BLVD, SUITE 220, PORT ORANGE, FL, 32128

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2017-09-22 No data No data

Documents

Name Date
ANNUAL REPORT 2016-01-25
ANNUAL REPORT 2015-03-19
ANNUAL REPORT 2014-03-03
Domestic Profit 2013-03-14

Related by officers

THOMAS BLAKE

INTRACOASTAL INSURANCE GROUP, INC. A-N-B LAWN CARE LLC BLT FUNDING LLC

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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