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  5. BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC.

BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC.

Company Details

Name: BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 16 Jun 1965 (60 years ago)
Business ID: 724208
ZIP code: 38732
County: Bolivar
State of Incorporation: MISSISSIPPI
Principal Office Address: 810 E. Sunflower Road , Suite 120Cleveland, MS 38732

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BOLIVAR COUNTY COMMUNITY ACTION AGENCY 2014 640434535 2015-08-31 BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC. 218
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2009-09-01
Business code 624410
Sponsor’s telephone number 6628461491
Plan sponsor’s mailing address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732
Plan sponsor’s address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732

Number of participants as of the end of the plan year
Active participants 215

Signature of
Role Plan administrator
Date 2015-08-07
Name of individual signing KIMBERLY NOLAN
Valid signature Filed with authorized/valid electronic signature
BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC. LIFE INSURANCE PLAN 2014 640434535 2015-08-31 BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC. 0
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2009-09-01
Business code 624410
Sponsor’s telephone number 6628461491
Plan sponsor’s mailing address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732
Plan sponsor’s address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732

Number of participants as of the end of the plan year
Active participants 218

Signature of
Role Plan administrator
Date 2015-08-07
Name of individual signing KIMBERLY NOLAN
Valid signature Filed with authorized/valid electronic signature
BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC. LIFE INSURANCE PLAN 2013 640434535 2015-09-10 BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC. 196
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2009-09-01
Business code 624410
Sponsor’s telephone number 6628461491
Plan sponsor’s mailing address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732
Plan sponsor’s address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732

Number of participants as of the end of the plan year
Active participants 174

Signature of
Role Plan administrator
Date 2015-09-10
Name of individual signing KIMBERLY NOLAN
Valid signature Filed with authorized/valid electronic signature
BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC. LIFE INSURANCE PLAN 2012 640434535 2015-09-10 BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC. 203
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2009-09-01
Business code 624410
Sponsor’s telephone number 6628461491
Plan sponsor’s mailing address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732
Plan sponsor’s address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732

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

Signature of
Role Plan administrator
Date 2015-09-10
Name of individual signing KIMBERLY NOLAN
Valid signature Filed with authorized/valid electronic signature
BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC. LIFE 2011 640434535 2015-09-10 BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC. 215
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2009-09-01
Business code 624410
Sponsor’s telephone number 6628461491
Plan sponsor’s mailing address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732
Plan sponsor’s address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732

Plan administrator’s name and address
Administrator’s EIN 640434535
Plan administrator’s name BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC.
Plan administrator’s address 810 E SUNFLOWER RD, SUITE 120, CLEVELAND, MS, 38732
Administrator’s telephone number 6628461491

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

Signature of
Role Plan administrator
Date 2015-09-10
Name of individual signing KIMBERLY NOLAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Elnora Littleton Agent 810 E Sunflower Road, Ste 120, Cleveland, MS 38732

Incorporator

Name Role Address
LOTTIE MAE NICHOLS Incorporator R, ROSEDALE, MS
R T SEARCY Incorporator C, CLEVELAND, MS
SAM D LONG Incorporator S, SHELBY, MS

President

Name Role Address
Nathan Towers President P. O. Box 158, Pace, MS 38764

Vice President

Name Role Address
Marshall Conico Vice President 1609 Bellavista Road, Cleveland, MS 38732

Secretary

Name Role Address
Chaka Smith Esq Secretary 218 North Street, Cleveland, MS 38732

Member

Name Role Address
Bertha Cummings Member 112 Belvedere Street, Cleveland, MS 38732
Hugh Smith MD Member 511 Robinson Drive, Cleveland, MS 38732
Deloris Brown Member P. O. Box 275, Shaw, MS 38773
Rita Marshall Member P. O. Box 94, Beulah, MS 38726
Kelvin Williams Member P. O. Box 539, Cleveland, MS 38732
David Kelly Member 404 West South Street, Mound Bayou, MS 38762
Tolernisa Butler Member 407 First Street, Shelby, MS 38774
Randy Bolden Member 302 Ronaldmen Road, Cleveland, MS 38732
Ashley Melvin Member 306 Maple Street, Mound Bayou, MS 38762

Filings

Type Status Filed Date Description
Non-Profit Status Report Filed 2022-06-03 Status Report For BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC.
Non-Profit Status Report Filed 2022-05-13 Status Report For BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC.
Non-Profit Status Report Filed 2021-08-19 Status Report For BOLIVAR COUNTY COMMUNITY ACTION AGENCY, INC.
Amendment Form Filed 2014-03-25 Amendment
Amendment Form Filed 2005-09-19 Amendment
See File Filed 2002-10-21 See File
Amendment Form Filed 2002-10-21 Amendment
See File Filed 1967-07-05 See File
See File Filed 1966-06-06 See File
See File Filed 1965-12-06 See File

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Date of last update: 28 Dec 2024

Sources: Mississippi Secretary of State

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