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  5. ROBERTS COMPANY, INC.

ROBERTS COMPANY, INC.

Company Details

Name: ROBERTS COMPANY, INC.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Good Standing
Effective Date: 05 Dec 1972 (52 years ago)
Business ID: 739264
ZIP code: 39401
County: Forrest
State of Incorporation: MISSISSIPPI
Principal Office Address: 1612 ADELINE STHATTIESBURG, MS 39401

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROBERTS COMPANY, INC. SAVINGS PLAN AND TRUST 2023 720719149 2024-10-08 ROBERTS COMPANY, INC. 508
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569

Number of participants as of the end of the plan year
Active participants 553
Retired or separated participants receiving benefits 4
Other retired or separated participants entitled to future benefits 29
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 259
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 12

Signature of
Role Plan administrator
Date 2024-10-08
Name of individual signing FORREST D ROBERTS
Valid signature Filed with authorized/valid electronic signature
ROBERTS COMPANY, INC. DISABILITY PLAN 2023 720719149 2024-04-24 ROBERTS COMPANY, INC. 184
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 198

Signature of
Role Plan administrator
Date 2024-04-24
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
ROBERTS COMPANY, INC. HEALTH, LIFE & DISABILITY 2022 720719149 2024-04-11 ROBERTS COMPANY, INC 439
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 500

Signature of
Role Plan administrator
Date 2024-04-11
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
ROBERTS COMPANY, INC. TERM LIFE INSURANCE PLAN 2022 720719149 2024-02-23 ROBERTS COMPANY, INC. 340
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address P. O. BOX 16569, HATTIESBURG, MS, 394010000
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 348

Signature of
Role Plan administrator
Date 2024-02-23
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
ROBERTS COMPANY, INC. VOLUNTARY GROUP DENTAL PLAN 2022 720719149 2024-06-06 ROBERTS COMPANY, INC. 311
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 0

Signature of
Role Plan administrator
Date 2024-06-05
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
ROBERTS COMPANY, INC. HEALTH, LIFE & DISABILITY 2022 720719149 2024-06-11 ROBERTS COMPANY, INC 439
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 500

Signature of
Role Plan administrator
Date 2024-06-05
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
ROBERTS COMPANY, INC. SAVINGS PLAN AND TRUST 2022 720719149 2023-10-12 ROBERTS COMPANY, INC. 541
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569

Number of participants as of the end of the plan year
Active participants 473
Retired or separated participants receiving benefits 4
Other retired or separated participants entitled to future benefits 31
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 265
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 12

Signature of
Role Plan administrator
Date 2023-10-12
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
ROBERTS COMPANY, INC. DISABILITY PLAN 2022 720719149 2023-05-23 ROBERTS COMPANY, INC. 172
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 184

Signature of
Role Plan administrator
Date 2023-05-23
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
ROBERTS COMPANY, INC. HEALTH, LIFE & DISABILITY 2021 720719149 2023-05-23 ROBERTS COMPANY, INC 423
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 439

Signature of
Role Plan administrator
Date 2023-05-23
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
ROBERTS COMPANY, INC. VOLUNTARY GROUP DENTAL PLAN 2021 720719149 2023-05-23 ROBERTS COMPANY, INC. 307
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 311

Signature of
Role Plan administrator
Date 2023-05-23
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2023/02/28/20230228103138NAL0000476755004.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address P. O. BOX 16569, HATTIESBURG, MS, 394010000
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 340

Signature of
Role Plan administrator
Date 2023-02-28
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2022/08/01/20220801091315NAL0020021408005.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 172

Signature of
Role Plan administrator
Date 2022-07-29
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2022/07/29/20220729092018NAL0010439394001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569

Number of participants as of the end of the plan year
Active participants 506
Retired or separated participants receiving benefits 3
Other retired or separated participants entitled to future benefits 32
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 259
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 10

Signature of
Role Plan administrator
Date 2022-07-29
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2022/08/01/20220801093828NAL0020047648001.pdf
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 423

Signature of
Role Plan administrator
Date 2022-07-29
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2022/08/01/20220801093828NAL0020047648002.pdf
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 307

Signature of
Role Plan administrator
Date 2022-07-29
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2022/05/16/20220516172302NAL0039643042001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address P. O. BOX 16569, HATTIESBURG, MS, 394010000
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 321

Signature of
Role Plan administrator
Date 2022-05-16
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2021/09/16/20210916093140NAL0008844963001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569

Number of participants as of the end of the plan year
Active participants 391
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 31
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 236
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 17

Signature of
Role Plan administrator
Date 2021-09-16
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2021/07/30/20210730092600NAL0011150049004.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 157

Signature of
Role Plan administrator
Date 2021-07-29
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2020/10/14/20201014152422NAL0004192035005.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 166

Signature of
Role Plan administrator
Date 2020-10-09
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2021/06/01/20210601194256NAL0026986194001.pdf
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 362

Signature of
Role Plan administrator
Date 2021-05-28
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2021/06/01/20210601194256NAL0026986194002.pdf
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 265

Signature of
Role Plan administrator
Date 2021-05-28
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2021/02/26/20210226144613NAL0007781297003.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address P. O. BOX 16569, HATTIESBURG, MS, 394010000
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 273

Signature of
Role Plan administrator
Date 2021-02-26
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569

Number of participants as of the end of the plan year
Active participants 442
Retired or separated participants receiving benefits 2
Other retired or separated participants entitled to future benefits 29
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 259
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 15

Signature of
Role Plan administrator
Date 2020-08-13
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2020/08/14/20200814082324NAL0006022529001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569

Number of participants as of the end of the plan year
Active participants 442
Retired or separated participants receiving benefits 2
Other retired or separated participants entitled to future benefits 29
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 259
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 15

Signature of
Role Plan administrator
Date 2020-08-14
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2020/05/29/20200529113340NAL0008382129001.pdf
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 335

Signature of
Role Plan administrator
Date 2020-05-29
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2020/05/29/20200529113340NAL0008382129002.pdf
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 244

Signature of
Role Plan administrator
Date 2020-05-29
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2020/02/19/20200219134153NAL0002725009001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address P. O. BOX 16569, HATTIESBURG, MS, 394010000
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 285

Signature of
Role Plan administrator
Date 2020-02-19
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/09/17/20190917123858P030001042677001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569

Number of participants as of the end of the plan year
Active participants 381
Retired or separated participants receiving benefits 2
Other retired or separated participants entitled to future benefits 28
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 257
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 12

Signature of
Role Plan administrator
Date 2019-09-17
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/07/30/20190730091144P040425749921004.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 161

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/05/31/20190531160220P030190424973002.pdf
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 330

Signature of
Role Plan administrator
Date 2019-05-30
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/05/31/20190531160220P030190424973003.pdf
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 232

Signature of
Role Plan administrator
Date 2019-05-30
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/02/28/20190228112821P040081641863002.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address P. O. BOX 16569, HATTIESBURG, MS, 394010000
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 284

Signature of
Role Plan administrator
Date 2019-02-28
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/07/27/20180727155940P040093032833001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569

Number of participants as of the end of the plan year
Active participants 394
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 45
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 264
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 18

Signature of
Role Plan administrator
Date 2018-07-27
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/05/30/20180530140614P040098162583002.pdf
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 231

Signature of
Role Plan administrator
Date 2018-05-30
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/07/09/20180709091745P040050259297004.pdf
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 336

Signature of
Role Plan administrator
Date 2018-07-06
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/02/27/20180227125332P040120859889002.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address P. O. BOX 16569, HATTIESBURG, MS, 394010000
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 279

Signature of
Role Plan administrator
Date 2018-02-26
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/08/03/20170803163128P030078864193001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1992-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569

Number of participants as of the end of the plan year
Active participants 408
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 41
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 282
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 13

Signature of
Role Plan administrator
Date 2017-08-03
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/24/20170724142000P030063005265005.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 149

Signature of
Role Plan administrator
Date 2017-07-21
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/02/28/20170228144144P030037724289001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address P. O. BOX 16569, HATTIESBURG, MS, 394010000
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 280

Signature of
Role Plan administrator
Date 2017-02-28
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/30/20170530160656P040052648545004.pdf
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 192

Signature of
Role Plan administrator
Date 2017-05-30
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/05/30/20170530160656P040052648545003.pdf
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 300

Signature of
Role Plan administrator
Date 2017-05-30
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/25/20160725170800P030049531431002.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 180

Signature of
Role Plan administrator
Date 2016-07-25
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/02/29/20160229094133P040016691287002.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 319

Signature of
Role Plan administrator
Date 2016-02-26
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/05/31/20160531123525P030099464881005.pdf
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 179

Signature of
Role Plan administrator
Date 2016-05-27
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/05/31/20160531123525P030099464881004.pdf
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 250

Signature of
Role Plan administrator
Date 2016-05-27
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/28/20150728164956P040142499089005.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Number of participants as of the end of the plan year
Active participants 120

Signature of
Role Plan administrator
Date 2015-07-21
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/05/28/20150528151318P030017231687001.pdf
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 217

Signature of
Role Plan administrator
Date 2015-05-27
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/03/17/20150317112120P030127014471001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Plan sponsor’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39402

Plan administrator’s name and address
Administrator’s EIN 720719149
Plan administrator’s name ROBERTS COMPANY, INC.
Plan administrator’s address 1612 ADELINE STREET,, HATTIESBURG, MS, 39401
Administrator’s telephone number 6015453411

Number of participants as of the end of the plan year
Active participants 307

Signature of
Role Plan administrator
Date 2015-03-17
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/03/17/20150317104948P030126996535003.pdf
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Number of participants as of the end of the plan year
Active participants 202

Signature of
Role Plan administrator
Date 2015-03-17
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/25/20140725121941P040023348605005.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39401

Plan administrator’s name and address
Administrator’s EIN 720719149
Plan administrator’s name FORREST ROBERTS
Plan administrator’s address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Administrator’s telephone number 6015453411

Number of participants as of the end of the plan year
Active participants 120

Signature of
Role Plan administrator
Date 2014-07-25
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/06/05/20130605100121P040246516867002.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address 1612 ADELINE STREET, HATTIESBURG, MS, 39404
Plan sponsor’s address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404

Plan administrator’s name and address
Administrator’s EIN 720719149
Plan administrator’s name FORREST ROBERTS
Plan administrator’s address 1612 ADELINE STREET, POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Administrator’s telephone number 6015453411

Number of participants as of the end of the plan year
Active participants 142

Signature of
Role Plan administrator
Date 2013-06-04
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/30/20120730103107P040018046514014.pdf
Three-digit plan number (PN) 506
Effective date of plan 2008-01-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address 1612 ADELINE STREET, HATTIESBURG, MS, 39404
Plan sponsor’s address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404

Plan administrator’s name and address
Administrator’s EIN 720719149
Plan administrator’s name FORREST ROBERTS
Plan administrator’s address 1612 ADELINE STREET, POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569
Administrator’s telephone number 6015453411

Number of participants as of the end of the plan year
Active participants 137

Signature of
Role Plan administrator
Date 2012-07-27
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/05/29/20120529161956P040077959232001.pdf
Three-digit plan number (PN) 501
Effective date of plan 1981-09-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address 1612 ADELINE STREET, HATTIESBURG, MS, 394046569
Plan sponsor’s address POST OFFICE BOX 16569, HATTIESBURG, MS, 394046569

Plan administrator’s name and address
Administrator’s EIN 720719149
Plan administrator’s name ROBERTS COMPANY INC
Plan administrator’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404
Administrator’s telephone number 6015453411

Number of participants as of the end of the plan year
Active participants 259

Signature of
Role Plan administrator
Date 2012-05-29
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/12/14/20111214125915P030001009280001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1992-02-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Plan administrator’s name and address
Administrator’s EIN 720719149
Plan administrator’s name ROBERTS COMPANY, INC.
Plan administrator’s address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Administrator’s telephone number 6015453411

Number of participants as of the end of the plan year
Active participants 236

Signature of
Role Plan administrator
Date 2011-12-13
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/12/14/20111214125859P030000217857001.pdf
Three-digit plan number (PN) 505
Effective date of plan 1997-11-01
Business code 445110
Sponsor’s telephone number 6015453411
Plan sponsor’s mailing address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Plan sponsor’s address 1612 ADELINE STREET, HATTIESBURG, MS, 39404

Plan administrator’s name and address
Administrator’s EIN 720719149
Plan administrator’s name ROBERTS COMPANY, INC.
Plan administrator’s address POST OFFICE BOX 16569, HATTIESBURG, MS, 39404
Administrator’s telephone number 6015453411

Number of participants as of the end of the plan year
Active participants 143

Signature of
Role Plan administrator
Date 2011-12-13
Name of individual signing FORREST ROBERTS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FORREST D ROBERTS Agent 1612 ADELINE ST, HATTIESBURG, MS 39401

Chief Executive Officer

Name Role Address
Forrest David Roberts III Chief Executive Officer 1 QUAIL HOLLOW, Hattiesburg, MS 39402

Director

Name Role Address
Forrest D Roberts Director 372 Jackson Rd, Hattiesburg, MS 39402

Chairman

Name Role Address
Forrest D Roberts Chairman 372 Jackson Rd, Hattiesburg, MS 39402

Filings

Type Status Filed Date Description
Annual Report Filed 2024-03-19 Annual Report For ROBERTS COMPANY, INC.
Annual Report Filed 2023-04-17 Annual Report For ROBERTS COMPANY, INC.
Annual Report Filed 2022-03-10 Annual Report For ROBERTS COMPANY, INC.
Restate Articles of Incorporation Filed 2021-10-14 Restatement For ROBERTS COMPANY, INC.
Annual Report Filed 2021-04-12 Annual Report For ROBERTS COMPANY, INC.
Annual Report Filed 2020-05-11 Annual Report For ROBERTS COMPANY, INC.
Annual Report Filed 2019-03-11 Annual Report For ROBERTS COMPANY, INC.
Annual Report Filed 2018-02-09 Annual Report For ROBERTS COMPANY, INC.
Annual Report Filed 2017-02-15 Annual Report For ROBERTS COMPANY, INC.
Annual Report Filed 2016-03-09 Annual Report For ROBERTS COMPANY, INC.

Related by officers

FORREST D ROBERTS

R & M FOODS, INC. EAGLE AVIATION OF HATTIESBURG, LLC Roberts Family Real Estate, LLC

Forrest David Roberts III

Magnolia Marketplace, LLC F&D Holdings, LLC

Forrest D Roberts

Ace Works, LLC ROYO, LLC York Roberts Oxford, LLC Rose Adelle Holdings, LLC

Related by address

1612 ADELINE STHATTIESBURG, MS 39401

R & M FOODS, INC. EAGLE AVIATION OF HATTIESBURG, LLC

Date of last update: 07 Jan 2025

Sources: Mississippi Secretary of State

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