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  5. AJFC COMMUNITY ACTION AGENCY, Inc

AJFC COMMUNITY ACTION AGENCY, Inc

Company Details

Name: AJFC COMMUNITY ACTION AGENCY, Inc
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 03 Aug 1966 (59 years ago)
Business ID: 102745
ZIP code: 39120
County: Adams
State of Incorporation: MISSISSIPPI
Principal Office Address: 8 Feltus St., 8 Feltus St.Natchez, MS 39120

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AJFC COMMUNITY ACTION AGENCY EMPLOYEE MEDICAL BENEFITS PLAN 2020 640442959 2022-07-15 AJFC COMMUNITY ACTION AGENCY 175
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2014-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 177

Signature of
Role Plan administrator
Date 2022-07-15
Name of individual signing CARMEN BROOKS DRAKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-15
Name of individual signing CARMEN BROOKS DRAKE
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2022-07-15
Name of individual signing DEANNE TANKSLEY
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF AJFC COMMUNITY ACTION AGENCY 2020 640442959 2021-11-15 AJFC COMMUNITY ACTION AGENCY 211
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 160
Other retired or separated participants entitled to future benefits 36
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 4
Number of participants with account balances as of the end of the plan year 197
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2

Signature of
Role Plan administrator
Date 2021-11-15
Name of individual signing CARMEN DRAKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-11-15
Name of individual signing CARMEN DRAKE
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2021-11-15
Name of individual signing DEANNE TANKSLEY
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF AJFC COMMUNITY ACTION AGENCY 2019 640442959 2020-11-13 AJFC COMMUNITY ACTION AGENCY 229
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 175
Other retired or separated participants entitled to future benefits 32
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 4
Number of participants with account balances as of the end of the plan year 206
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 6

Signature of
Role Plan administrator
Date 2020-11-05
Name of individual signing CARMEN BROOKS DRAKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-11-05
Name of individual signing CARMEN BROOKS DRAKE
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2020-11-05
Name of individual signing DEANNE L. TANKSLEY
Valid signature Filed with authorized/valid electronic signature
AJFC COMMUNITY ACTION AGENCY EMPLOYEE MEDICAL BENEFITS PLAN 2019 640442959 2021-05-05 AJFC COMMUNITY ACTION AGENCY 184
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2014-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 175

Signature of
Role Plan administrator
Date 2021-05-05
Name of individual signing CARMEN BROOKS DRAKE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-05
Name of individual signing CARMEN BROOKS DRAKE
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2021-05-05
Name of individual signing DEANNE TANKSLEY
Valid signature Filed with authorized/valid electronic signature
AJFC COMMUNITY ACTION AGENCY EMPLOYEE MEDICAL BENEFITS PLAN 2018 640442959 2020-04-30 AJFC COMMUNITY ACTION AGENCY 185
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2014-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 184
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2020-04-30
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-04-30
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2020-04-30
Name of individual signing DEANNE TANKSLEY
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF AJFC COMMUNITY ACTION AGENCY 2018 640442959 2019-10-01 AJFC COMMUNITY ACTION AGENCY 209
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 192
Other retired or separated participants entitled to future benefits 34
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 3
Number of participants with account balances as of the end of the plan year 223
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 5

Signature of
Role Plan administrator
Date 2019-09-19
Name of individual signing SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-19
Name of individual signing SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2019-09-19
Name of individual signing DEANNE L. TANKSLEY
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF AJFC COMMUNITY ACTION AGENCY 2018 640442959 2019-09-26 AJFC COMMUNITY ACTION AGENCY 209
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 192
Other retired or separated participants entitled to future benefits 34
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 3
Number of participants with account balances as of the end of the plan year 223
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 5

Signature of
Role Plan administrator
Date 2019-09-19
Name of individual signing SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-19
Name of individual signing SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2019-09-19
Name of individual signing DEANNE L. TANKSLEY
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF AJFC COMMUNITY ACTION AGENCY 2017 640442959 2018-11-15 AJFC COMMUNITY ACTION AGENCY 222
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 182
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 25
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2
Number of participants with account balances as of the end of the plan year 206
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 3

Signature of
Role Plan administrator
Date 2018-11-15
Name of individual signing SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-11-15
Name of individual signing SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2018-11-15
Name of individual signing DEANNE L. TANKSLEY
Valid signature Filed with authorized/valid electronic signature
AJFC COMMUNITY ACTION AGENCY EMPLOYEE MEDICAL BENEFITS PLAN 2017 640442959 2019-05-28 AJFC COMMUNITY ACTION AGENCY 182
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2014-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 185

Signature of
Role Plan administrator
Date 2019-05-23
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-23
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2019-05-23
Name of individual signing DEANNE TANKSLEY
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF AJFC COMMUNITY ACTION AGENCY 2017 640442959 2018-11-16 AJFC COMMUNITY ACTION AGENCY 222
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 182
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 25
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2
Number of participants with account balances as of the end of the plan year 206
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 3

Signature of
Role Plan administrator
Date 2018-11-15
Name of individual signing SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-11-15
Name of individual signing SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2018-11-15
Name of individual signing DEANNE L. TANKSLEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/05/08/20180508155202P030055248423002.pdf
Three-digit plan number (PN) 501
Effective date of plan 2014-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 182

Signature of
Role Plan administrator
Date 2018-04-30
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-30
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2018-04-30
Name of individual signing DEANNE TANKSLEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/03/12/20180312121853P030005662313001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 196

Signature of
Role Plan administrator
Date 2017-08-07
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-07
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2017-08-07
Name of individual signing DEANNE L. TANKSLEY
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 501
Effective date of plan 2014-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 198

Signature of
Role Plan administrator
Date 2018-04-30
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-30
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2018-04-30
Name of individual signing DEANNE TANKSLEY
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 196

Signature of
Role Plan administrator
Date 2017-08-07
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-07
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2017-08-07
Name of individual signing DEANNE L. TANKSLEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/31/20170731115245P030057116653001.pdf
Three-digit plan number (PN) 501
Effective date of plan 2014-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 198

Signature of
Role Plan administrator
Date 2017-05-01
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-01
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2017-05-01
Name of individual signing DEANNE TANKSLEY
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 501
Effective date of plan 2014-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 198

Signature of
Role Plan administrator
Date 2017-05-01
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-01
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2017-05-01
Name of individual signing DEANNE TANKSLEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/11/15/20161115170832P040012194407001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 187
Other retired or separated participants entitled to future benefits 23
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2
Number of participants with account balances as of the end of the plan year 212
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 11

Signature of
Role Plan administrator
Date 2016-11-10
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-11-10
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role DFE
Date 2016-11-10
Name of individual signing DEANNE L. TANKSLEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/15/20160715164652P040035882449003.pdf
Three-digit plan number (PN) 501
Effective date of plan 2000-10-01
Business code 624200
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 0

Signature of
Role Plan administrator
Date 2016-04-13
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/15/20160715164652P040035882449002.pdf
Three-digit plan number (PN) 501
Effective date of plan 2014-10-01
Business code 624200
Sponsor’s telephone number 6014018681
Plan sponsor’s mailing address P.O. BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 NORTH UNION STREET, NATCHEZ, MS, 391202875

Number of participants as of the end of the plan year
Active participants 198

Signature of
Role Plan administrator
Date 2016-04-13
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Other retired or separated participants entitled to future benefits 19
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 4
Number of participants with account balances as of the end of the plan year 164
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 5

Signature of
Role Plan administrator
Date 2015-07-27
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-27
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/06/07/20160607125809P040107027297002.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Other retired or separated participants entitled to future benefits 19
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 4
Number of participants with account balances as of the end of the plan year 164
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 5

Signature of
Role Plan administrator
Date 2015-07-27
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-27
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/06/07/20160607125807P040107027153001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 145
Other retired or separated participants entitled to future benefits 16
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 162
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 2014-11-06
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-11-06
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 145
Other retired or separated participants entitled to future benefits 16
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 162
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 2014-11-06
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-11-06
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 145
Other retired or separated participants entitled to future benefits 16
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 162
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 2014-11-06
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-11-06
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 501
Effective date of plan 2000-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address PO BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N. UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 231

Signature of
Role Plan administrator
Date 2014-07-15
Name of individual signing SANDRA SEWELL
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2014-07-15
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/15/20140715173904P040013428271004.pdf
Three-digit plan number (PN) 501
Effective date of plan 2000-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address PO BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N. UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 231

Signature of
Role Plan administrator
Date 2014-07-15
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-15
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/15/20140715173904P040013428271003.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 158
Other retired or separated participants entitled to future benefits 9
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2
Number of participants with account balances as of the end of the plan year 169
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of
Role Plan administrator
Date 2013-08-15
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-15
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Number of participants as of the end of the plan year
Active participants 158
Other retired or separated participants entitled to future benefits 9
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2
Number of participants with account balances as of the end of the plan year 169
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of
Role Plan administrator
Date 2013-08-15
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-15
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/21/20131021092653P030047929011002.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Plan administrator’s name and address
Administrator’s EIN 640442959
Plan administrator’s name AJFC COMMUNITY ACTION AGENCY
Plan administrator’s address P O BOX L, NATCHEZ, MS, 39121
Administrator’s telephone number 6014428681

Number of participants as of the end of the plan year
Active participants 157
Number of participants with account balances as of the end of the plan year 166
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2

Signature of
Role Plan administrator
Date 2012-08-15
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-15
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/29/20130729141305P030046008583002.pdf
Three-digit plan number (PN) 501
Effective date of plan 2000-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address PO BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N. UNION STREET, NATCHEZ, MS, 39120

Plan administrator’s name and address
Administrator’s EIN 640442959
Plan administrator’s name AJFC COMMUNITY ACTION AGENCY
Plan administrator’s address PO BOX L, NATCHEZ, MS, 39121
Administrator’s telephone number 6014428681

Number of participants as of the end of the plan year
Active participants 187

Signature of
Role Plan administrator
Date 2013-07-22
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-22
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Plan administrator’s name and address
Administrator’s EIN 640442959
Plan administrator’s name AJFC COMMUNITY ACTION AGENCY
Plan administrator’s address P O BOX L, NATCHEZ, MS, 39121
Administrator’s telephone number 6014428681

Number of participants as of the end of the plan year
Active participants 157
Number of participants with account balances as of the end of the plan year 166
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2

Signature of
Role Plan administrator
Date 2012-08-15
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-15
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/16/20120716140122P040000386323005.pdf
Three-digit plan number (PN) 501
Effective date of plan 2000-10-01
Business code 624200
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address PO BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N. UNION STREET, NATCHEZ, MS, 39120

Plan administrator’s name and address
Administrator’s EIN 640442959
Plan administrator’s name AJFC COMMUNITY ACTION AGENCY
Plan administrator’s address PO BOX L, NATCHEZ, MS, 39121
Administrator’s telephone number 6014428681

Number of participants as of the end of the plan year
Active participants 203

Signature of
Role Plan administrator
Date 2012-07-13
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-13
Name of individual signing SANDRA SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/08/15/20110815171726P030016544194003.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Plan administrator’s name and address
Administrator’s EIN 640442959
Plan administrator’s name AJFC COMMUNITY ACTION AGENCY
Plan administrator’s address P O BOX L, NATCHEZ, MS, 39121
Administrator’s telephone number 6014428681

Number of participants as of the end of the plan year
Active participants 146
Other retired or separated participants entitled to future benefits 9
Number of participants with account balances as of the end of the plan year 155

Signature of
Role Plan administrator
Date 2011-08-03
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-08-03
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/11/15/20101115094718P040000822514008.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 813000
Sponsor’s telephone number 6014428681
Plan sponsor’s mailing address P O BOX L, NATCHEZ, MS, 39121
Plan sponsor’s address 1038 N UNION STREET, NATCHEZ, MS, 39120

Plan administrator’s name and address
Administrator’s EIN 640442959
Plan administrator’s name AJFC COMMUNITY ACTION AGENCY
Plan administrator’s address P O BOX L, NATCHEZ, MS, 39121
Administrator’s telephone number 6014428681

Number of participants as of the end of the plan year
Active participants 140
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 7
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 148
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of
Role Plan administrator
Date 2010-11-08
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-11-08
Name of individual signing MS. SANDRA D. SEWELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Zadier Thomas Agent 8 Feltus St., Natchez, MS 39120

Incorporator

Name Role Address
ALBERT E LEHMANN Incorporator P O BOX 236, FAYETTE, MS 39069
FARAR M TRULY Incorporator P O BOX 426, FAYETTE, MS
JOHN C BERRY Incorporator P O BOX 68, FAYETTE, MS
R J ALLEN Incorporator P O BOX 248, FAYETTE, MS

President

Name Role Address
Kenneth Thrasher President 8 Feltus St., Natchez, MS 39120

Chairman

Name Role Address
Kenneth Thrasher Chairman 8 Feltus St., Natchez, MS 39120

Director

Name Role Address
Zadier Thomas Director 8 Feltus St., Natchez, MS 39120

Chief Executive Officer

Name Role Address
Zadier Thomas Chief Executive Officer 8 Feltus St., Natchez, MS 39120

Chief Financial Officer

Name Role Address
YaMika Thomas Chief Financial Officer 8 Feltus St., Natchez, MS 39120

Filings

Type Status Filed Date Description
Non-Profit Status Report Filed 2023-10-23 Status Report For AJFC COMMUNITY ACTION AGENCY, Inc
Amendment Form Filed 2010-12-21 Amendment
Correction Amendment Form Filed 2005-01-07 Correction
Amendment Form Filed 1990-07-11 Amendment
Amendment Form Filed 1978-04-07 Amendment
Undetermined Event Filed 1966-08-11 Undetermined Event
Name Reservation Form Filed 1966-08-03 Name Reservation

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
04SE3419 Department of Health and Human Services 93.708 - ARRA - HEAD START 2009-07-01 2010-09-30 HEAD START 2009 ARRA COLA QUALITY IMPROVEMENT FUNDING.
Recipient AJFC COMMUNITY ACTION AGENCY INC
Recipient Name Raw AJFC COMMUNITY ACTION AGENCY
Recipient UEI EC92K9BG8F98
Recipient DUNS 100336346
Recipient Address P.O. BOX L, NATCHEZ, ADAMS, MISSISSIPPI, 39121-1056, UNITED STATES
Obligated Amount 495862.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
04CH3419 Department of Health and Human Services 93.600 - HEAD START No data No data PA-22 FYPD
Recipient AJFC COMMUNITY ACTION AGENCY
Recipient Name Raw AJFC COMMUNITY ACTION AGENCY
Recipient DUNS 118994334
Recipient Address POST OFFICE BOX L, NATCHEZ, ADAMS, MISSISSIPPI, 39121
Obligated Amount 55640130.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
64-0442959 Corporation Unconditional Exemption 8 FELTUS ST, NATCHEZ, MS, 39120-4243 1967-09
In Care of Name % ZADIER THOMAS
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-01
Asset 1,000,000 to 4,999,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Jan
Asset Amount 1105411
Income Amount 3680631
Form 990 Revenue Amount 3680631
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name AJFC COMMUNITY ACTION AGENCY
EIN 64-0442959
Tax Period 202201
Filing Type E
Return Type 990
File View File
Organization Name AJFC COMMUNITY ACTION AGENCY
EIN 64-0442959
Tax Period 202101
Filing Type E
Return Type 990
File View File
Organization Name AJFC COMMUNITY ACTION AGENCY
EIN 64-0442959
Tax Period 202001
Filing Type E
Return Type 990
File View File
Organization Name AJFC COMMUNITY ACTION AGENCY
EIN 64-0442959
Tax Period 201901
Filing Type E
Return Type 990
File View File
Organization Name AJFC COMMUNITY ACTION AGENCY
EIN 64-0442959
Tax Period 201701
Filing Type E
Return Type 990
File View File
Organization Name AJFC COMMUNITY ACTION AGENCY
EIN 64-0442959
Tax Period 201601
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6762768010 2020-06-30 0470 PPP 1038 UNION ST, NATCHEZ, MS, 39120-2875
Loan Status Date 2022-04-23
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1347100
Loan Approval Amount (current) 1347100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39638
Servicing Lender Name United Mississippi Bank
Servicing Lender Address 75 Melrose Montebello Pkwy, NATCHEZ, MS, 39120-4747
Rural or Urban Indicator R
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address NATCHEZ, ADAMS, MS, 39120-2875
Project Congressional District MS-03
Number of Employees 210
NAICS code 925120
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 39638
Originating Lender Name United Mississippi Bank
Originating Lender Address NATCHEZ, MS
Gender Female Owned
Veteran Unanswered
Forgiveness Amount 1363676.81
Forgiveness Paid Date 2021-09-17

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Date of last update: 10 Apr 2025

Sources: Mississippi Secretary of State

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