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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

Related by officers

Zadier Thomas

Sugar and Spice Sparkle Bar on Wheels, LLC

ALBERT E LEHMANN

ADAMS-JEFFERSON IMPROVEMENT CORPORATION

FARAR M TRULY

JEFFERSON COUNTY CITIZENS' COUNCIL JEFFERSON COUNTY CENTER, INC.

JOHN C BERRY

BEAR'S GYM, LTD. ADAMS-JEFFERSON IMPROVEMENT CORPORATION HATTIESBURG COMMUNITY GROUP OF EMERGENCY SCHOOL ASSISTANCE PROGRAM (ESAP) INCORPORATED CLEVELAND ATHLETICS, INC. WORLDS AWAY, LLC JCB DISTRIBUTION, LLC

R J ALLEN

JEFFERSON COUNTY CHAMBER OF COMMERCE, INC. JEFFERSON COUNTY DEVELOPMENT ASSOCIATION JEFFERSON COUNTY COLD STORAGE AAL JEFFERSON COUNTY EROSION CONTROL ASSOCIATION (A.A.L.) JEFFERSON COUNTY FARM BUREAU, (A.A.L.) ADAMS-JEFFERSON IMPROVEMENT CORPORATION

Kenneth Thrasher

Safe Place Daycare and Learning Center, LLC

Related by address

No related companies by address

Date of last update: 24 Jan 2025

Sources: Mississippi Secretary of State

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