| Entity Name: | MARSHALL MEDICAL FORMS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 23 Dec 1991 (33 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | V01773 |
| FEI/EIN Number | 59-3105818 |
| Address: | 1190 Rollingwood Tr, maitland, FL 32751 |
| Mail Address: | 1190 Rolllingwood Trail, Maitland, FL 32751 |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARSHALL MEDICAL DEFINED BENEFIT PENSION PLAN | 2011 | 593105818 | 2012-10-03 | MARSHALL MEDICAL FORMS | 7 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 593105818 |
| Plan administrator’s name | MARSHALL MEDICAL FORMS |
| Plan administrator’s address | 707 NICHOLET AVENUE, SUITE 102, WINTER PARK, FL, 32789 |
| Administrator’s telephone number | 4075392260 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-03 |
| Name of individual signing | BEVERLY ALEXANDER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-10-03 |
| Name of individual signing | BEVERLY ALEXANDER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 424100 |
| Sponsor’s telephone number | 4075392260 |
| Plan sponsor’s address | 707 NICHOLET AVENUE, SUITE 102, WINTER PARK, FL, 32789 |
Plan administrator’s name and address
| Administrator’s EIN | 593105818 |
| Plan administrator’s name | MARSHALL MEDICAL FORMS |
| Plan administrator’s address | 707 NICHOLET AVENUE, SUITE 102, WINTER PARK, FL, 32789 |
| Administrator’s telephone number | 4075392260 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-11 |
| Name of individual signing | BEVERLY ALEXANDER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-10-11 |
| Name of individual signing | BEVERLY ALEXANDER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 424100 |
| Sponsor’s telephone number | 4075392260 |
| Plan sponsor’s address | 707 NICHOLET AVENUE, SUITE 102, WINTER PARK, FL, 32789 |
Plan administrator’s name and address
| Administrator’s EIN | 593105818 |
| Plan administrator’s name | MARSHALL MEDICAL FORMS |
| Plan administrator’s address | 707 NICHOLET AVENUE, SUITE 102, WINTER PARK, FL, 32789 |
| Administrator’s telephone number | 4075392260 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-08 |
| Name of individual signing | BEVERLY ALEXANDER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-10-08 |
| Name of individual signing | BEVERLY ALEXANDER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| HATCHER, STEPHEN BESQ. | Agent | C/O ZIMMERMAN, KISER & SUTCLIFFE, P.A., 315 E. ROBINSON STREET, SUITE 600, ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| ALEXANDER, BEVERLY A | President | 1190 ROLLINGWOOD TRAIL, MAITLAND, FL 32751 |
| Name | Role | Address |
|---|---|---|
| ALEXANDER, BEVERLY A | Secretary | 1190 ROLLINGWOOD TRAIL, MAITLAND, FL 32751 |
| Name | Role | Address |
|---|---|---|
| ALEXANDER, BEVERLY A | Treasurer | 1190 ROLLINGWOOD TRAIL, MAITLAND, FL 32751 |
| Name | Role | Address |
|---|---|---|
| ALEXANDER, BEVERLY A | Director | 1190 ROLLINGWOOD TRAIL, MAITLAND, FL 32751 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000013841 | THE MARSHALL SOLUTIONS GROUP | EXPIRED | 2010-02-11 | 2015-12-31 | No data | POST OFFICE BOX 940217, MAITLAND, FL, 32794 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-02-13 | 1190 Rollingwood Tr, maitland, FL 32751 | No data |
| CHANGE OF MAILING ADDRESS | 2013-03-25 | 1190 Rollingwood Tr, maitland, FL 32751 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-02-11 | HATCHER, STEPHEN BESQ. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-02-11 | C/O ZIMMERMAN, KISER & SUTCLIFFE, P.A., 315 E. ROBINSON STREET, SUITE 600, ORLANDO, FL 32801 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-01-19 |
| ANNUAL REPORT | 2016-03-13 |
| ANNUAL REPORT | 2015-02-24 |
| ANNUAL REPORT | 2014-02-13 |
| ANNUAL REPORT | 2013-03-25 |
| ANNUAL REPORT | 2012-01-09 |
| ANNUAL REPORT | 2011-02-21 |
| ANNUAL REPORT | 2010-02-11 |
| ANNUAL REPORT | 2009-04-03 |
| ANNUAL REPORT | 2008-01-11 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
