| Name: | CLEVELAND MEDICAL CLINIC, PLLC |
| Jurisdiction: | MISSISSIPPI |
| Business Type: | Limited Liability Company |
| Status: | Dissolved |
| Effective Date: | 07 Aug 2003 (21 years ago) |
| Business ID: | 737451 |
| ZIP code: | 38732 |
| County: | Bolivar |
| State of Incorporation: | MISSISSIPPI |
| Principal Office Address: | 810 E. SUNFLOWER ROAD SUITE 100ACLEVELAND, MS 38732 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLEVELAND MEDICAL CLINIC, PLLC 401K PLAN | 2014 | 200167329 | 2015-07-20 | CLEVELAND MEDICAL CLINIC, PLLC | 48 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2015-07-20 |
| Name of individual signing | STEVEN CLARK |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 6628433606 |
| Plan sponsor’s address | 810 E. SUNFLOWER RD., STE. 100A, CLEVELAND, MS, 387322828 |
Signature of
| Role | Plan administrator |
| Date | 2014-09-23 |
| Name of individual signing | STEVEN CLARK |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GERALD H JACKS | Agent | 150 North Sharpe Avenue;PO Box 1209, Cleveland, MS 38732 |
| Name | Role | Address |
|---|---|---|
| Charles F Brock | Manager | 810 E. SUNFLOWER RD. SUITE 100A, CLEVELAND, MS 38732 |
| Name | Role | Address |
|---|---|---|
| Steven Clark | Member | 810 E. SUNFLOWER RD SUITE 100A, CLEVELAND, MS 38732 |
| CHARLES F BROCK JR | Member | 498 HILLCREST CIRCLE, CLEVELAND, MS 38732 |
| Type | Status | Filed Date | Description |
|---|---|---|---|
| Dissolution | Filed | 2020-10-05 | Dissolution For CLEVELAND MEDICAL CLINIC, PLLC |
| Notice to Dissolve/Revoke | Filed | 2020-08-28 | Notice to Dissolve/Revoke |
| Annual Report LLC | Filed | 2019-03-19 | Annual Report For CLEVELAND MEDICAL CLINIC, PLLC |
| Annual Report LLC | Filed | 2018-03-28 | Annual Report For CLEVELAND MEDICAL CLINIC, PLLC |
| Annual Report LLC | Filed | 2017-03-27 | Annual Report For CLEVELAND MEDICAL CLINIC, PLLC |
| Annual Report LLC | Filed | 2016-04-02 | Annual Report For CLEVELAND MEDICAL CLINIC, PLLC |
| Annual Report LLC | Filed | 2015-01-06 | Annual Report For CLEVELAND MEDICAL CLINIC, PLLC |
| Annual Report LLC | Filed | 2014-01-14 | Annual Report LLC |
| Annual Report LLC | Filed | 2013-01-29 | Annual Report LLC |
| Annual Report LLC | Filed | 2012-04-11 | Annual Report LLC |
Date of last update: 07 Jan 2025
Sources: Mississippi Secretary of State
