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  5. JACKSON EYE ASSOCIATES, PLLC

JACKSON EYE ASSOCIATES, PLLC

Company Details

Name: JACKSON EYE ASSOCIATES, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 14 Apr 2000 (25 years ago)
Business ID: 685572
ZIP code: 39202
County: Hinds
State of Incorporation: MISSISSIPPI
Principal Office Address: 1200 North State Street, Suite 330Jackson, MS 39202

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING 2023 640918286 2024-04-25 JACKSON EYE ASSOCIATES, PLLC 89
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2024-04-25
Name of individual signing JULIE YOUNG
Valid signature Filed with authorized/valid electronic signature
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING 2022 640918286 2023-06-13 JACKSON EYE ASSOCIATES, PLLC 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2023-06-13
Name of individual signing JULIE YOUNG
Valid signature Filed with authorized/valid electronic signature
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING 2021 640918286 2022-05-23 JACKSON EYE ASSOCIATES, PLLC 94
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2022-05-23
Name of individual signing MICHAEL SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-23
Name of individual signing MICHAEL SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING 2020 640918286 2021-09-15 JACKSON EYE ASSOCIATES, PLLC 100
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2021-09-15
Name of individual signing SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-15
Name of individual signing SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING 2020 640918286 2021-06-24 JACKSON EYE ASSOCIATES, PLLC 100
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2021-06-24
Name of individual signing SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-06-24
Name of individual signing SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING 2019 640918286 2020-06-23 JACKSON EYE ASSOCIATES, PLLC 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2020-06-23
Name of individual signing SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-23
Name of individual signing SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING 2018 640918286 2019-05-14 JACKSON EYE ASSOCIATES, PLLC 93
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2019-05-14
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-14
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING 2017 640918286 2018-06-28 JACKSON EYE ASSOCIATES, PLLC 78
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2018-06-28
Name of individual signing SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-28
Name of individual signing SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING 2017 640918286 2019-06-17 JACKSON EYE ASSOCIATES, PLLC 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 39202
JACKSON EYE ASSOCIATES, PLLC PROFIT SHARING PLAN 2016 640918286 2017-09-19 JACKSON EYE ASSOCIATES, PLLC 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 330, JACKSON, MS, 392022027
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/17/20161017152645P030033911889001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 N. STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing LISA DOUGLAS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/04/20161004172033P030008041575001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 N. STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2016-10-04
Name of individual signing LISA DOUGLAS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 N. STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/14/20141014142424P040004301333001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 N. STATE STREET, SUITE 330, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2014-10-14
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/09/20131009154005P030035121617001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1200 NORTH STATE STREET, SUITE 300, JACKSON, MS, 39202

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-09
Name of individual signing JACKSON EYE ASSOCIATES, PLLC
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/15/20121015143829P040006622897001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1190 NORTH STATE ST., SUITE 403, JACKSON, MS, 39202

Plan administrator’s name and address
Administrator’s EIN 640918286
Plan administrator’s name JACKSON EYE ASSOCIATES, PLLC
Plan administrator’s address 1190 NORTH STATE ST., SUITE 403, JACKSON, MS, 39202
Administrator’s telephone number 6013532020

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/06/22/20110622160710P030080564481001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1190 NORTH STATE ST., SUITE 403, JACKSON, MS, 39202

Plan administrator’s name and address
Administrator’s EIN 640918286
Plan administrator’s name JACKSON EYE ASSOCIATES, PLLC
Plan administrator’s address 1190 NORTH STATE ST., SUITE 403, JACKSON, MS, 39202
Administrator’s telephone number 6013532020

Signature of
Role Plan administrator
Date 2011-06-22
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1190 NORTH STATE STREET, SUITE 403, JACKSON, MS, 39202

Plan administrator’s name and address
Administrator’s EIN 640918286
Plan administrator’s name JACKSON EYE ASSOCIATES, INC.
Plan administrator’s address 1190 NORTH STATE STREET, SUITE 403, JACKSON, MS, 39202
Administrator’s telephone number 6013532020

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-10-13
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with incorrect/unrecognized electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1190 NORTH STATE STREET, SUITE 403, JACKSON, MS, 39202

Plan administrator’s name and address
Administrator’s EIN 640918286
Plan administrator’s name JACKSON EYE ASSOCIATES, INC.
Plan administrator’s address 1190 NORTH STATE STREET, SUITE 403, JACKSON, MS, 39202
Administrator’s telephone number 6013532020

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with incorrect/unrecognized electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/20/20110120145957P040017334113001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1190 NORTH STATE STREET, SUITE 403, JACKSON, MS, 39202

Plan administrator’s name and address
Administrator’s EIN 640918286
Plan administrator’s name JACKSON EYE ASSOCIATES, INC.
Plan administrator’s address 1190 NORTH STATE STREET, SUITE 403, JACKSON, MS, 39202
Administrator’s telephone number 6013532020

Signature of
Role Plan administrator
Date 2011-01-20
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 6013532020
Plan sponsor’s address 1190 NORTH STATE STREET, SUITE 403, JACKSON, MS, 39202

Plan administrator’s name and address
Administrator’s EIN 640918286
Plan administrator’s name JACKSON EYE ASSOCIATES, INC.
Plan administrator’s address 1190 NORTH STATE STREET, SUITE 403, JACKSON, MS, 39202
Administrator’s telephone number 6013532020

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing M. SHANE HUMPHRIES
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Address
JACKSON EYE ASSOCIATES, PLLC, ATTN: SHANE HUMPHRIES Agent 1200 North State Street, Suite 330, JACKSON, MS 39202

Manager

Name Role Address
EYE SYSTEMS, INC. Manager 1200 NORTH STATE ST, SUITE 330, JACKSON, MS 39202
Shane Humphries Manager 1200 NORTH STATE ST, SUITE 330, JACKSON, MS 39202

Member

Name Role Address
EYE SYSTEMS, INC. Member 1200 NORTH STATE ST, SUITE 330, JACKSON, MS 39202
WILLIAM B GRETE Member 1200 N STATE ST #330, JACKSON, MS 39202

Other

Name Role Address
Shane Humphries Other 1200 NORTH STATE ST, SUITE 330, JACKSON, MS 39202

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2024-01-25 Annual Report For JACKSON EYE ASSOCIATES, PLLC
Annual Report LLC Filed 2023-01-19 Annual Report For JACKSON EYE ASSOCIATES, PLLC
Annual Report LLC Filed 2022-01-16 Annual Report For JACKSON EYE ASSOCIATES, PLLC
Annual Report LLC Filed 2021-01-27 Annual Report For JACKSON EYE ASSOCIATES, PLLC
Annual Report LLC Filed 2020-01-24 Annual Report For JACKSON EYE ASSOCIATES, PLLC
Annual Report LLC Filed 2019-04-01 Annual Report For JACKSON EYE ASSOCIATES, PLLC
Annual Report LLC Filed 2018-03-14 Annual Report For JACKSON EYE ASSOCIATES, PLLC
Annual Report LLC Filed 2017-02-28 Annual Report For JACKSON EYE ASSOCIATES, PLLC
Annual Report LLC Filed 2016-02-15 Annual Report For JACKSON EYE ASSOCIATES, PLLC
Amendment Form Filed 2015-10-08 Amendment For JACKSON EYE ASSOCIATES, PLLC

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Date of last update: 26 Dec 2024

Sources: Mississippi Secretary of State

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