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  5. JEFFERSON MEDICAL ASSOCIATES, P.A.

JEFFERSON MEDICAL ASSOCIATES, P.A.

Company Details

Name: JEFFERSON MEDICAL ASSOCIATES, P.A.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 01 Oct 1980 (44 years ago)
Business ID: 656872
ZIP code: 39440
County: Jones
State of Incorporation: MISSISSIPPI
Principal Office Address: 1203 Jefferson StreetLaurel, MS 39440-4370

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE BENEFIT PLAN OF JEFFERSON MEDICAL ASSOCIATES, P.A. 2018 640641399 2019-10-14 JEFFERSON MEDICAL ASSOCIATES, P.A. 159
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621399
Sponsor’s telephone number 6016492863
Plan sponsor’s mailing address 1203 JEFFERSON ST, LAUREL, MS, 394404354
Plan sponsor’s address 1203 JEFFERSON ST, LAUREL, MS, 394404354

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 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 2019-10-14
Name of individual signing WILLUS HORNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-14
Name of individual signing WILLUS HORNE
Valid signature Filed with authorized/valid electronic signature
JEFFERSON MEDICAL ASSOCIATES, P.A. PROFIT SHARING PLAN AND TRUST 2012 640641399 2013-10-14 JEFFERSON MEDICAL ASSOCIATES, P.A. 140
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 6016492863
Plan sponsor’s mailing address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Plan sponsor’s address JEFFERSON MEDICAL ASSOCIATES, P.A., 1203 JEFFERSON STREET, LAUREL, MS, 39440

Number of participants as of the end of the plan year
Active participants 108
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 37
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 146
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 2013-10-14
Name of individual signing WILLUS MARK HORNE, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-14
Name of individual signing WILLUS MARK HORNE, MD
Valid signature Filed with authorized/valid electronic signature
JEFFERSON MEDICAL ASSOCIATES, P.A. PROFIT SHARING PLAN AND TRUST 2011 640641399 2012-10-12 JEFFERSON MEDICAL ASSOCIATES, P.A. 141
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 6016492863
Plan sponsor’s mailing address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Plan sponsor’s address JEFFERSON MEDICAL ASSOCIATES, P.A., 1203 JEFFERSON STREET, LAUREL, MS, 39440

Plan administrator’s name and address
Administrator’s EIN 640641399
Plan administrator’s name JEFFERSON MEDICAL ASSOCIATES, P.A.
Plan administrator’s address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Administrator’s telephone number 6016492863

Number of participants as of the end of the plan year
Active participants 97
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 37
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 134
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 2012-10-12
Name of individual signing WILLIAM MARK HORNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-12
Name of individual signing WILLIAM MARK HORNE
Valid signature Filed with authorized/valid electronic signature
JEFFERSON MEDICAL ASSOCIATES, P.A. PROFIT SHARING PLAN AND TRUST 2010 640641399 2012-06-20 JEFFERSON MEDICAL ASSOCIATES, P.A. 133
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 6016492863
Plan sponsor’s mailing address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Plan sponsor’s address JEFFERSON MEDICAL ASSOCIATES, P.A., 1203 JEFFERSON STREET, LAUREL, MS, 39440

Plan administrator’s name and address
Administrator’s EIN 640641399
Plan administrator’s name JEFFERSON MEDICAL ASSOCIATES, P.A.
Plan administrator’s address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Administrator’s telephone number 6016492863

Number of participants as of the end of the plan year
Active participants 98
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 33
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 132
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 2012-06-20
Name of individual signing WILLUS HORNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-20
Name of individual signing WILLUS HORNE
Valid signature Filed with authorized/valid electronic signature
JEFFERSON MEDICAL ASSOCIATES, P.A. PROFIT SHARING PLAN AND TRUST 2010 640641399 2011-07-07 JEFFERSON MEDICAL ASSOCIATES, P.A. 133
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 6016492863
Plan sponsor’s mailing address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Plan sponsor’s address JEFFERSON MEDICAL ASSOCIATES, P.A., 1203 JEFFERSON STREET, LAUREL, MS, 39440

Plan administrator’s name and address
Administrator’s EIN 640641399
Plan administrator’s name JEFFERSON MEDICAL ASSOCIATES, P.A.
Plan administrator’s address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Administrator’s telephone number 6016492863

Number of participants as of the end of the plan year
Active participants 98
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 33
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 132
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 2011-07-07
Name of individual signing WILLIAM MARK HORNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-07
Name of individual signing WILLIAM MARK HORNE
Valid signature Filed with authorized/valid electronic signature
JEFFERSON MEDICAL ASSOCIATES, P.A. PROFIT SHARING PLAN AND TRUST 2009 640641399 2010-07-28 JEFFERSON MEDICAL ASSOCIATES, P.A. 137
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 6016492863
Plan sponsor’s mailing address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Plan sponsor’s address JEFFERSON MEDICAL ASSOCIATES, P.A., 1203 JEFFERSON STREET, LAUREL, MS, 39440

Plan administrator’s name and address
Administrator’s EIN 640641399
Plan administrator’s name JEFFERSON MEDICAL ASSOCIATES, P.A.
Plan administrator’s address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Administrator’s telephone number 6016492863

Number of participants as of the end of the plan year
Active participants 91
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 37
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 129
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-07-28
Name of individual signing MARK HORNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-28
Name of individual signing MARK HORNE
Valid signature Filed with authorized/valid electronic signature
JEFFERSON MEDICAL ASSOCIATES, P.A. PROFIT SHARING PLAN AND TRUST 2009 640641399 2010-07-28 JEFFERSON MEDICAL ASSOCIATES, P.A. 137
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 6016492863
Plan sponsor’s mailing address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Plan sponsor’s address JEFFERSON MEDICAL ASSOCIATES, P.A., 1203 JEFFERSON STREET, LAUREL, MS, 39440

Plan administrator’s name and address
Administrator’s EIN 640641399
Plan administrator’s name JEFFERSON MEDICAL ASSOCIATES, P.A.
Plan administrator’s address 1203 JEFFERSON STREET, LAUREL, MS, 39440
Administrator’s telephone number 6016492863

Number of participants as of the end of the plan year
Active participants 91
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 37
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 129
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-07-28
Name of individual signing MARK HORNE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-28
Name of individual signing MARK HORNE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Home, Willus Mark Agent 1203 Jefferson Street, Laurel, MS 39440

Director

Name Role Address
Mark Horne, MD Director 1203 Jefferson St, Laurel, MS 39440
James M. Beasley M.D. Director 1203 Jefferson Street, Laurel, MS 39440
Charles Cannon M.D. Director 1203 Jefferson Street, Laurel, MS 39440

Other

Name Role Address
Mark Horne, MD Other 1203 Jefferson St, Laurel, MS 39440

President

Name Role Address
Mark Horne, MD President 1203 Jefferson St, Laurel, MS 39440

Vice President

Name Role Address
James M. Beasley M.D. Vice President 1203 Jefferson Street, Laurel, MS 39440

Secretary

Name Role Address
Charles Cannon M.D. Secretary 1203 Jefferson Street, Laurel, MS 39440

Treasurer

Name Role Address
Charles Cannon M.D. Treasurer 1203 Jefferson Street, Laurel, MS 39440

Filings

Type Status Filed Date Description
Dissolution Filed 2019-10-01 Dissolution For JEFFERSON MEDICAL ASSOCIATES, P.A.
Annual Report Filed 2019-01-09 Annual Report For JEFFERSON MEDICAL ASSOCIATES, P.A.
Annual Report Filed 2018-01-08 Annual Report For JEFFERSON MEDICAL ASSOCIATES, P.A.
Annual Report Filed 2017-01-26 Annual Report For JEFFERSON MEDICAL ASSOCIATES, P.A.
Annual Report Filed 2016-01-14 Annual Report For JEFFERSON MEDICAL ASSOCIATES, P.A.
Reinstatement Filed 2016-01-14 Reinstatement For JEFFERSON MEDICAL ASSOCIATES, P.A.
Admin Dissolution Filed 2015-12-08 Admin Dissolution: AR
Notice to Dissolve/Revoke Filed 2015-09-16 Notice to Dissolve/Revoke
Annual Report Filed 2014-11-03 Annual Report For JEFFERSON MEDICAL ASSOCIATES, P.A.
Notice to Dissolve/Revoke Filed 2014-10-13 Notice to Dissolve/Revoke

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 25 Dec 2024

Sources: Mississippi Secretary of State

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