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  5. MR. SAM, INC.

MR. SAM, INC.

Company Details

Entity Name: MR. SAM, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 09 Nov 2015 (9 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 14 Nov 2016 (8 years ago)
Document Number: P15000092222
FEI/EIN Number 47-5592471
Address: 11257 WATER OAK PL, DAVIE, FL, 33330
Mail Address: 11257 WATER OAK PL, DAVIE, FL, 33330
ZIP code: 33330
County: Broward
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MR SAM INC 401(K) PROFIT SHARING PLAN & TRUST 2023 475592471 2024-06-04 MR SAM INC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 812990
Sponsor’s telephone number 9542788300
Plan sponsor’s address 1250 S PINE ISLAND ROAD, SUITE 345, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2024-06-04
Name of individual signing MARTIN SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
MR SAM INC 401(K) PROFIT SHARING PLAN & TRUST 2022 475592471 2023-08-16 MR SAM INC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 812990
Sponsor’s telephone number 9542788300
Plan sponsor’s address 1250 S PINE ISLAND ROAD, SUITE 345, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2023-08-16
Name of individual signing MARTIN SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
MR SAM INC 401(K) PROFIT SHARING PLAN & TRUST 2021 475592471 2022-06-28 MR SAM INC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 812990
Sponsor’s telephone number 9542788300
Plan sponsor’s address 1250 S PINE ISLAND ROAD, SUITE 345, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2022-06-28
Name of individual signing MARTIN SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
MR SAM INC 401(K) PROFIT SHARING PLAN & TRUST 2020 475592471 2021-05-26 MR SAM INC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 812990
Sponsor’s telephone number 9542788300
Plan sponsor’s address 1250 S PINE ISLAND ROAD, SUITE 345, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2021-05-26
Name of individual signing MARTIN SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
MR SAM INC 401(K) PROFIT SHARING PLAN & TRUST 2019 475592471 2020-07-01 MR SAM INC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 812990
Sponsor’s telephone number 9542788300
Plan sponsor’s address 1250 S PINE ISLAND ROAD, SUITE 345, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2020-07-01
Name of individual signing MARTIN SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
MR SAM INC 401 K PROFIT SHARING PLAN TRUST 2018 475592471 2019-05-16 MR SAM INC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 812990
Sponsor’s telephone number 9542788300
Plan sponsor’s address 1250 S PINE ISLAND ROAD, SUITE 345, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2019-05-16
Name of individual signing MARTIN SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
MR SAM INC 401 K PROFIT SHARING PLAN TRUST 2017 475592471 2018-07-12 MR SAM INC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 812990
Sponsor’s telephone number 9542788300
Plan sponsor’s address 1250 S PINE ISLAND ROAD, SUITE 345, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2018-07-12
Name of individual signing MILDRED GOLBOIS
Valid signature Filed with authorized/valid electronic signature
MR SAM INC 401 K PROFIT SHARING PLAN TRUST 2016 475592471 2017-06-27 MR SAM INC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 812990
Sponsor’s telephone number 9542788300
Plan sponsor’s address 1250 S PINE ISLAND ROAD, SUITE 345, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2017-06-27
Name of individual signing MILDRED GOLBOIS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SCHWARTZ MARTIN Agent 11257 WATER OAK PL, DAVIE, FL, 33330

President

Name Role Address
SCHWARTZ MARTIN President 11257 WATER OAK PL, DAVIE, FL, 33330

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000122364 ANSWERQUEST TECHNOLOGIES ACTIVE 2015-12-04 2025-12-31 No data 11257 WATER OAK PLACE, DAVIE, FL, 33330

Events

Event Type Filed Date Value Description
REINSTATEMENT 2016-11-14 No data No data
REGISTERED AGENT NAME CHANGED 2016-11-14 SCHWARTZ, MARTIN No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2016-09-23 No data No data

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-02-28
ANNUAL REPORT 2022-03-09
ANNUAL REPORT 2021-03-15
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-02-13
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-01-24
REINSTATEMENT 2016-11-14
Domestic Profit 2015-11-09

Related by officers

SCHWARTZ MARTIN

PIT BULL INC. BUILDING 135, INC V, SUNRISE LAKES PHASE 111 KOL LEON HOLDINGS FL LLC INTEGRATIVE BARIATRICS, INC. DOREL, INC. THE VILLAGE HOME OWNERS ASSOCIATION OF OCALA, INC. SAMP INC. MSS ASSOC. INC.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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