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  5. EXECUSYS, INC.

EXECUSYS, INC.

Company Details

Entity Name: EXECUSYS, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 18 Mar 1993 (32 years ago)
Document Number: P93000020449
FEI/EIN Number 593173232
Address: 1230 Palm Garden Place, MELBOURNE, FL, 32940, US
Mail Address: 1230 Palm Garden Place, MELBOURNE, FL, 32940, US
ZIP code: 32940
County: Brevard
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EXECUSYS, INC. 401K PLAN 2012 593173232 2013-04-26 EXECUSYS, INC. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-10-01
Business code 541511
Sponsor’s telephone number 3212530077
Plan sponsor’s mailing address 6767 NORTH WICKHAM ROAD, SUITE 508, MELBOURNE, FL, 32940
Plan sponsor’s address 6767 NORTH WICKHAM ROAD, SUITE 508, MELBOURNE, FL, 32940

Plan administrator’s name and address
Administrator’s EIN 593173232
Plan administrator’s name EXECUSYS, INC.
Plan administrator’s address 6767 NORTH WICKHAM ROAD, SUITE 508, MELBOURNE, FL, 32940
Administrator’s telephone number 3212530077

Number of participants as of the end of the plan year
Active participants 28
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 15
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 33
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-04-26
Name of individual signing ROBERTA NORWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-26
Name of individual signing ROBERTA NORWELL
Valid signature Filed with authorized/valid electronic signature
EXECUSYS, INC. 401K PLAN 2011 593173232 2012-04-04 EXECUSYS, INC. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-10-01
Business code 541511
Sponsor’s telephone number 3212530077
Plan sponsor’s mailing address 6767 NORTH WICKHAM ROAD, SUITE 508, MELBOURNE, FL, 32940
Plan sponsor’s address 6767 NORTH WICKHAM ROAD, SUITE 508, MELBOURNE, FL, 32940

Plan administrator’s name and address
Administrator’s EIN 593173232
Plan administrator’s name EXECUSYS, INC.
Plan administrator’s address 6767 NORTH WICKHAM ROAD, SUITE 508, MELBOURNE, FL, 32940
Administrator’s telephone number 3212530077

Number of participants as of the end of the plan year
Active participants 29
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 16
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 37
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-04-04
Name of individual signing ROBERTA NORWELL
Valid signature Filed with authorized/valid electronic signature
EXECUSYS, INC. 401K PLAN 2010 593173232 2011-04-14 EXECUSYS, INC. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-10-01
Business code 541511
Sponsor’s telephone number 3212530077
Plan sponsor’s mailing address 6767 NORTH WICKHAM ROAD, SUITE #508, MELBOURNE, FL, 32940
Plan sponsor’s address 6767 NORTH WICKHAM ROAD, SUITE #508, MELBOURNE, FL, 32940

Plan administrator’s name and address
Administrator’s EIN 593173232
Plan administrator’s name EXECUSYS, INC.
Plan administrator’s address 6767 NORTH WICKHAM ROAD, SUITE #508, MELBOURNE, FL, 32940
Administrator’s telephone number 3212530077

Number of participants as of the end of the plan year
Active participants 29
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 19
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 39
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-04-14
Name of individual signing ROBERTA NORWELL
Valid signature Filed with authorized/valid electronic signature
EXECUSYS, INC. 401K PLAN 2009 593173232 2010-04-08 EXECUSYS, INC. 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-10-01
Business code 541511
Sponsor’s telephone number 3212530077
Plan sponsor’s mailing address 6767 NORTH WICKHAM ROAD, SUITE #508, MELBOURNE, FL, 32940
Plan sponsor’s address 6767 NORTH WICKHAM ROAD, SUITE #508, MELBOURNE, FL, 32940

Plan administrator’s name and address
Administrator’s EIN 593173232
Plan administrator’s name EXECUSYS, INC.
Plan administrator’s address 6767 NORTH WICKHAM ROAD, SUITE #508, MELBOURNE, FL, 32940
Administrator’s telephone number 3212530077

Number of participants as of the end of the plan year
Active participants 29
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 19
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 40
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-04-08
Name of individual signing ROBERTA NORWELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Thomas James A Agent 1230 PALM GARDEN PL, MELBOURNE, FL, 32940

President

Name Role Address
Thomas James A President 1230 Palm Garden Place, Melbourne, FL, 32940

Vice President

Name Role Address
Haralson Eddie CSr. Vice President P.O. Box 560752, Rockledge, FL, 329560752

Treasurer

Name Role Address
VANDERWERKEN DANIEL G Treasurer 2355 BAYHILL DR., VIERA, FL, 32940

Secretary

Name Role Address
THOMAS JAMES J Secretary 102 Woodland Drive, Morganton, NC, 28655

Exec

Name Role Address
Norwell Roberta A Exec 1349 California Drive, Melbourne, FL, 32940

Events

Event Type Filed Date Value Description
REINSTATEMENT 2024-04-18 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 No data No data
AMENDMENT 2011-12-06 No data No data
AMENDMENT 1993-10-15 No data No data

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Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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