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  5. SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY

SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY

Headquarter

Company Details

Name: SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Good Standing
Effective Date: 31 Oct 1946 (78 years ago)
Business ID: 402130
ZIP code: 39213
County: Hinds
State of Incorporation: MISSISSIPPI
Principal Office Address: 1401 Livingston LaneJackson, MS 39213

Links between entities

Type Company Name Company Number State
Headquarter of SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY, ALABAMA 000-856-473 ALABAMA
Headquarter of SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY, COLORADO 20111332198 COLORADO
Headquarter of SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY, FLORIDA 807453 FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHERN FARM BUREAU GROUP HEALTH AND MEDICAL INSURANCE PLAN FOR EMPLOYEES 2023 640283583 2024-10-15 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 794
File View Page
Three-digit plan number (PN) 525
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address PO BOX 78, JACKSON, MS, 392050078

Number of participants as of the end of the plan year
Active participants 718
Retired or separated participants receiving benefits 55

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing MELISSA ROBBINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-15
Name of individual signing MELISSA ROBBINS
Valid signature Filed with authorized/valid electronic signature
SOUTHERN FARM BUREAU LIFE INS CO. EMPLOYEES AD&D PLAN 2022 640283583 2024-02-27 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 600
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 641930786
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address PO BOX 78, JACKSON, MS, 392050078
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 622

Signature of
Role Plan administrator
Date 2024-02-27
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN FARM BUREAU INSURANCE TRUST DISABILITY 2022 640283583 2024-02-27 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 4619
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Number of participants as of the end of the plan year
Active participants 4396
Retired or separated participants receiving benefits 84

Signature of
Role Plan administrator
Date 2024-02-27
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN FARM BUREAU GROUP HEALTH AND MEDICAL INSURANCE PLAN FOR EMPLOYEES 2022 640283583 2023-10-16 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 639
File View Page
Three-digit plan number (PN) 525
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address PO BOX 78, JACKSON, MS, 392050078

Number of participants as of the end of the plan year
Active participants 563
Retired or separated participants receiving benefits 60

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN FARM BUREAU INSURANCE TRUST DISABILITY 2021 640283583 2023-02-28 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 4854
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Number of participants as of the end of the plan year
Active participants 4547
Retired or separated participants receiving benefits 72

Signature of
Role Plan administrator
Date 2023-02-28
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN FARM BUREAU GROUP HEALTH AND MEDICAL INSURANCE PLAN FOR EMPLOYEES 2021 640283583 2022-10-13 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 681
File View Page
Three-digit plan number (PN) 525
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address PO BOX 78, JACKSON, MS, 392050078

Number of participants as of the end of the plan year
Active participants 595
Retired or separated participants receiving benefits 67

Signature of
Role Plan administrator
Date 2022-10-13
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN FARM BUREAU LIFE INS CO. EMPLOYEES AD&D PLAN 2021 640283583 2023-01-30 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 629
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 600

Signature of
Role Plan administrator
Date 2023-01-30
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-01-30
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN FARM BUREAU INSURANCE TRUST DISABILITY 2020 640283583 2022-02-25 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 4706
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P O BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Number of participants as of the end of the plan year
Active participants 4783
Retired or separated participants receiving benefits 71

Signature of
Role Plan administrator
Date 2022-02-25
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN FARM BUREAU LIFE INS CO. EMPLOYEES AD&D PLAN 2020 640283583 2022-01-20 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 652
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 629

Signature of
Role Plan administrator
Date 2022-01-19
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-01-19
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
SOUTHERN FARM BUREAU GROUP HEALTH AND MEDICAL INSURANCE PLAN FOR EMPLOYEES 2020 640283583 2021-10-15 SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY 666
File View Page
Three-digit plan number (PN) 525
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address PO BOX 78, JACKSON, MS, 392050078

Number of participants as of the end of the plan year
Active participants 666
Retired or separated participants receiving benefits 87

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-15
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2021/01/28/20210128133033NAL0008674067001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 654

Signature of
Role Plan administrator
Date 2021-01-28
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2020/10/15/20201015103408NAL0007911169001.pdf
Three-digit plan number (PN) 525
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address PO BOX 78, JACKSON, MS, 392050078

Number of participants as of the end of the plan year
Active participants 580
Retired or separated participants receiving benefits 88

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2021/02/25/20210225144700NAL0010091552001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Number of participants as of the end of the plan year
Active participants 4628
Retired or separated participants receiving benefits 78

Signature of
Role Plan administrator
Date 2021-02-25
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2020/01/21/20200121090111NAL0001057763001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name JOYCE PLUNKETT
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 652

Signature of
Role Plan administrator
Date 2020-01-21
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-01-21
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/11/21/20191121133012P040156979425001.pdf
Three-digit plan number (PN) 525
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address PO BOX 78, JACKSON, MS, 392050078

Number of participants as of the end of the plan year
Active participants 580
Retired or separated participants receiving benefits 83

Signature of
Role Plan administrator
Date 2019-11-21
Name of individual signing MELISSA ROBBINS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2020/02/10/20200210144454NAL0013428465001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Number of participants as of the end of the plan year
Active participants 4613
Retired or separated participants receiving benefits 75

Signature of
Role Plan administrator
Date 2020-02-10
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-02-10
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/01/17/20190117083009P040000038853001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Number of participants as of the end of the plan year
Active participants 3572
Retired or separated participants receiving benefits 67

Signature of
Role Plan administrator
Date 2019-01-16
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/01/16/20190116161119P030168590279001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name JOYCE PLUNKETT
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 640

Signature of
Role Plan administrator
Date 2019-01-16
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/07/27/20180727140425P030064404349001.pdf
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Number of participants as of the end of the plan year
Active participants 562
Retired or separated participants receiving benefits 66
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1

Signature of
Role Plan administrator
Date 2018-07-27
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/01/23/20180123084902P040024315741001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name JOYCE PLUNKETT
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 633

Signature of
Role Plan administrator
Date 2018-01-22
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/11/29/20171129090748P040140525391001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address PO BOX 78, JACKSON, MS, 392050078
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address PO BOX 78, JACKSON, MS, 392050078
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 3613
Retired or separated participants receiving benefits 72

Signature of
Role Plan administrator
Date 2017-11-28
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/26/20170726143456P040070470337001.pdf
Three-digit plan number (PN) 507
Effective date of plan 2005-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 579
Other retired or separated participants entitled to future benefits 69
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/26/20170726143409P030059983319001.pdf
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 571
Retired or separated participants receiving benefits 69
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing JOYCE PLUNKETT
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/11/17/20161117140347P040014769015001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 646

Signature of
Role Plan administrator
Date 2016-11-17
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/12/07/20161207090154P030090800535001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 3472
Retired or separated participants receiving benefits 76

Signature of
Role Plan administrator
Date 2016-12-07
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/08/31/20160831094505P040010261095001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1982-02-02
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address 1401 LIVINGSTON LANE, JACKSON, MS, 39213
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640288243
Plan administrator’s name SOUTHERN FARM BUREAU CASUALTY INSURANCE COMPANY
Plan administrator’s address 1800 E COUNTY LINE RD, RIDGELAND, MS, 391571916
Administrator’s telephone number 6019574495

Number of participants as of the end of the plan year
Number of participants with account balances as of the end of the plan year 0
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 2016-08-30
Name of individual signing LAURA WATKINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-31
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/28/20160728141441P030054087655001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1982-02-02
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address 1401 LIVINGSTON LANE, JACKSON, MS, 39213
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640288243
Plan administrator’s name SOUTHERN FARM BUREAU CASUALTY INSURANCE COMPANY
Plan administrator’s address 1800 E. COUNTY LINE ROAD SUITE 400, RIDGELAND, MS, 39157
Administrator’s telephone number 6019574495

Number of participants as of the end of the plan year
Active participants 721
Retired or separated participants receiving benefits 14
Other retired or separated participants entitled to future benefits 159
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 6
Number of participants with account balances as of the end of the plan year 829
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 2016-07-28
Name of individual signing LAURA WATKINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-28
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/27/20160727100025P040050907943001.pdf
Three-digit plan number (PN) 507
Effective date of plan 2005-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 578
Retired or separated participants receiving benefits 73
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 3

Signature of
Role Plan administrator
Date 2016-07-27
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/27/20160727095958P040050907239001.pdf
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 566
Retired or separated participants receiving benefits 72
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 3

Signature of
Role Plan administrator
Date 2016-07-27
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/02/23/20160223132929P030010516647001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 3554
Retired or separated participants receiving benefits 60

Signature of
Role Plan administrator
Date 2016-02-23
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/01/15/20160115130617P030171310625001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 655

Signature of
Role Plan administrator
Date 2016-01-15
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/29/20150729151246P040046094141001.pdf
Three-digit plan number (PN) 507
Effective date of plan 2005-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 584
Retired or separated participants receiving benefits 60
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2015-07-29
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/29/20150729151204P030040851053001.pdf
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 573
Retired or separated participants receiving benefits 136
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 6

Signature of
Role Plan administrator
Date 2015-07-29
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/20/20150720111909P030106558823001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1982-02-02
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address 1401 LIVINGSTON LANE, JACKSON, MS, 39213
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640288243
Plan administrator’s name SOUTHERN FARM BUREAU CASUALTY INSURANCE COMPANY
Plan administrator’s address 1800 E. COUNTY LINE ROAD SUITE 400, RIDGELAND, MS, 39157
Administrator’s telephone number 6019574495

Number of participants as of the end of the plan year
Active participants 697
Retired or separated participants receiving benefits 13
Other retired or separated participants entitled to future benefits 146
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 767
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 2015-07-20
Name of individual signing LAURA WATKINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-20
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/02/19/20150219134901P040097919111001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 3593
Retired or separated participants receiving benefits 68

Signature of
Role Plan administrator
Date 2015-02-19
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/01/21/20150121153345P040075209137001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 669

Signature of
Role Plan administrator
Date 2015-01-21
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/12/08/20141208102121P040046783197001.pdf
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 576
Retired or separated participants receiving benefits 131
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 7

Signature of
Role Plan administrator
Date 2014-11-21
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/12/08/20141208101010P030045703823001.pdf
Three-digit plan number (PN) 507
Effective date of plan 2005-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Number of participants as of the end of the plan year
Active participants 581
Retired or separated participants receiving benefits 45

Signature of
Role Plan administrator
Date 2014-12-08
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/31/20140731153235P040021224383001.pdf
Three-digit plan number (PN) 507
Effective date of plan 2005-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 581
Retired or separated participants receiving benefits 45

Signature of
Role Plan administrator
Date 2014-07-31
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P O BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P O BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Signature of
Role Plan administrator
Date 2014-07-31
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/22/20140722165321P030004371525001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1982-02-02
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address 1401 LIVINGSTON LANE, JACKSON, MS, 39213
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640288243
Plan administrator’s name SOUTHERN FARM BUREAU CASUALTY INSURANCE COMPANY
Plan administrator’s address 1800 E. COUNTY LINE ROAD SUITE 400, RIDGELAND, MS, 39157
Administrator’s telephone number 6019574495

Number of participants as of the end of the plan year
Active participants 713
Retired or separated participants receiving benefits 13
Other retired or separated participants entitled to future benefits 146
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 767
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 2014-07-22
Name of individual signing LAURA WATKINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-22
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/02/18/20140218135220P030217330227001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 3601
Retired or separated participants receiving benefits 80

Signature of
Role Plan administrator
Date 2014-02-18
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/01/30/20140130102454P030065949125001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 687

Signature of
Role Plan administrator
Date 2014-01-30
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/28/20130728152712P040118808053001.pdf
Three-digit plan number (PN) 507
Effective date of plan 2005-01-01
Business code 524140
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205

Number of participants as of the end of the plan year
Active participants 572
Retired or separated participants receiving benefits 45

Signature of
Role Plan administrator
Date 2013-07-28
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/28/20130728151211P040118796309001.pdf
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P O BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P O BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 571
Retired or separated participants receiving benefits 113
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 10

Signature of
Role Plan administrator
Date 2013-07-28
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/22/20130722104530P040114799221001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1982-02-02
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address 1401 LIVINGSTON LANE, JACKSON, MS, 39213
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640288243
Plan administrator’s name SOUTHERN FARM BUREAU CASUALTY INSURANCE COMPANY
Plan administrator’s address 1800 E. COUNTY LINE ROAD SUITE 400, RIDGELAND, MS, 39157
Administrator’s telephone number 6019574495

Number of participants as of the end of the plan year
Active participants 694
Retired or separated participants receiving benefits 13
Other retired or separated participants entitled to future benefits 126
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 765
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 2013-07-22
Name of individual signing LAURA WATKINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-22
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/02/28/20130228160843P030112055011001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 3665
Retired or separated participants receiving benefits 75

Signature of
Role Plan administrator
Date 2013-02-28
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/11/20/20121120154413P030043252866001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 683

Signature of
Role Plan administrator
Date 2012-11-20
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/31/20120731093040P030001899796001.pdf
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P O BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P O BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 581
Retired or separated participants receiving benefits 112
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 6

Signature of
Role Plan administrator
Date 2012-07-31
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/31/20120731151153P040020198706001.pdf
Three-digit plan number (PN) 507
Effective date of plan 2005-01-01
Business code 524140
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205

Number of participants as of the end of the plan year
Active participants 596
Retired or separated participants receiving benefits 41

Signature of
Role Plan administrator
Date 2012-07-31
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/16/20120716111016P030005409410001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1982-02-02
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address 1401 LIVINGSTON LANE, JACKSON, MS, 39213
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640288243
Plan administrator’s name SOUTHERN FARM BUREAU CASUALTY INSURANCE COMPANY
Plan administrator’s address 1800 E. COUNTY LINE ROAD SUITE 400, RIDGELAND, MS, 39157
Administrator’s telephone number 6019574495

Number of participants as of the end of the plan year
Active participants 706
Retired or separated participants receiving benefits 20
Other retired or separated participants entitled to future benefits 112
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 756
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 2012-07-16
Name of individual signing LAURA WATKINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-12
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 3677
Retired or separated participants receiving benefits 72

Signature of
Role Plan administrator
Date 2012-02-22
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/02/29/20120229145735P030044544129001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 3677
Retired or separated participants receiving benefits 72

Signature of
Role Plan administrator
Date 2012-02-29
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 661

Signature of
Role Plan administrator
Date 2011-11-09
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/11/10/20111110161810P040000096867001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 661

Signature of
Role Plan administrator
Date 2011-11-10
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/29/20110729151541P030482137120001.pdf
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P O BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P O BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 1115
Retired or separated participants receiving benefits 199
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 24

Signature of
Role Plan administrator
Date 2011-07-29
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/26/20110726142648P040103726945001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1982-02-02
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address 1401 LIVINGSTON LANE, JACKSON, MS, 39213
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640288243
Plan administrator’s name SOUTHERN FARM BUREAU CASUALTY INSURANCE COMPANY
Plan administrator’s address 1800 E. COUNTY LINE ROAD SUITE 400, RIDGELAND, MS, 39157
Administrator’s telephone number 6019574495

Number of participants as of the end of the plan year
Active participants 672
Retired or separated participants receiving benefits 27
Other retired or separated participants entitled to future benefits 105
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 742
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 2011-07-26
Name of individual signing LAURA WATKINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-26
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/02/28/20110228110756P040002673474001.pdf
Three-digit plan number (PN) 502
Effective date of plan 1962-08-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JCKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 4880
Retired or separated participants receiving benefits 98
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2011-02-28
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/27/20110127132326P040000262337001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1987-07-01
Business code 524290
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P.O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P.O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 658

Signature of
Role Plan administrator
Date 2011-01-27
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/25/20110125093317P030019941137001.pdf
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 640283583
Plan administrator’s name SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 1111
Retired or separated participants receiving benefits 209
Other retired or separated participants entitled to future benefits 0
Number of participants with account balances as of the end of the plan year 24
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1344

Signature of
Role Plan administrator
Date 2011-01-25
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 503
Effective date of plan 1983-01-01
Business code 524140
Sponsor’s telephone number 6019817422
Plan sponsor’s mailing address P. O. BOX 78, JACKSON, MS, 39205
Plan sponsor’s address 1401 LIVINGSTON LANE, JACKSON, MS, 39213

Plan administrator’s name and address
Administrator’s EIN 581930786
Plan administrator’s name BILLY SIMS
Plan administrator’s address P. O. BOX 78, JACKSON, MS, 39205
Administrator’s telephone number 6019817422

Number of participants as of the end of the plan year
Active participants 1111
Retired or separated participants receiving benefits 209
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 24

Signature of
Role Plan administrator
Date 2010-07-30
Name of individual signing BILLY SIMS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 109 Executive Drive, Suite 3, Madison, MS 39110

Incorporator

Name Role Address
C D MADDOX Incorporator W, WEST, MS
H D BLAND Incorporator N, NEWTON, MS
RANSOM E ALDRICH Incorporator No data

Chief Executive Officer

Name Role Address
DAVID B HURT Chief Executive Officer 1401 Livingston Lane, Jackson, MS 39213

Director

Name Role Address
MARK MCDOWELL Director 1401 Livingston Lane, JACKSON, MS 39213
Marty Wooldridge Director 1401 Livingston Lane, Jackson, MS 39213
Sam Snyder Director 1401 Livingston Lane, Jackson, MS 39213
Shane Wiseman Director 1401 Livingston Lane, Jackson, MS 39213
Dan Wright Director 1401 Livingston Lane, Jackson, MS 39213

Secretary

Name Role Address
William Perry McGaugh Secretary 1401 Livingston Lane, Jackson, MS 39213

Treasurer

Name Role Address
David Mark Simmonds Treasurer 1401 Livingston Lane, Jackson, MS 39213

Filings

Type Status Filed Date Description
Annual Report Filed 2024-03-20 Annual Report For SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Annual Report Filed 2023-04-15 Annual Report For SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Amendment Form Filed 2023-04-15 Amendment For SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Registered Agent Change of Address Filed 2022-03-31 Agent Address Change For CORPORATION SERVICE COMPANY
Amendment Form Filed 2018-03-28 Amendment For SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Amendment Form Filed 2015-08-25 Amendment For SOUTHERN FARM BUREAU LIFE INSURANCE COMPANY
Merger Filed 2010-12-30 Merger
Amendment Form Filed 2008-02-19 Amendment
Amendment Form Filed 1999-06-21 Amendment
See File Filed 1998-12-21 See File

Related by officers

CORPORATION SERVICE COMPANY

SELOX, INC. SENTELL BROTHERS, INCORPORATED THE LOUISIANA LAND AND EXPLORATION COMPANY SCHLUMBERGER TECHNOLOGY CORPORATION SCOTTSBORO TV CABLE, INC. Doosan Bobcat North America, Inc. COAST MATERIALS COMPANY COCA-COLA BOTTLING COMPANY, INC., OF VICKSBURG COLONIAL PIPELINE COMPANY COLUMBIA GULF TRANSMISSION COMPANY

C D MADDOX

MISSISSIPPI FARM BUREAU MARKETING ASSOCIATION (A. A. L.) ATTALA COUNTY EROSION CONTROL ASSOCIATION, (A.A.L.) ATTALA COUNTY FARM SERVICE COMPANY (AAL)

RANSOM E ALDRICH

THE COOPERATIVE FARMER PUBLISHING COMPANY

William Perry McGaugh

SFBLIC Aviation, LLC

Dan Wright

RURAL INSURANCE AGENCY Southern Casualty Holding Company Colorado Farm Bureau Insurance Company

Related by address

1401 Livingston LaneJackson, MS 39213

MR PROPERTIES, LLC SRE Holdings, LLC Mem-Monroe, LLC

Date of last update: 14 Dec 2024

Sources: Mississippi Secretary of State

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