Detail by Officer/Registered Agent Name

Florida Not For Profit Corporation

THE FLORIDA INSURANCE FORUM, INC.

Filing Information
N97000007212 54-1882908 12/30/1997 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/14/2007 NONE
Principal Address
127 SOUTH PEYTON STREET, #210
ALEXANDRIA, VA 22314

Changed: 11/07/2006
Mailing Address
127 SOUTH PEYTON STREET, #210
ALEXANDRIA, VA 22314

Changed: 11/07/2006
Registered Agent Name & Address CORPAMERICA, INC.
1201 HAYS STREET
TALLAHASSEE, FL 32301

Name Changed: 01/31/2001

Address Changed: 08/01/2003
Officer/Director Detail Name & Address

Title DT

WIESKE, J.P.
127 SOUTH PEYTON STREET
ALEXANDRIA, VA 22314

Title DS

HAMPTON, MIKE
7440 WOODLAND DRIVE
INDIANAPOLIS, IN 46279

Title CDP

ETERNO, MARIANNE
1275 MILWAUKEE AVE
GLENVIEW, IL 60025

Title P

ETERNO, MARIANNE
1275 MILWAUKEE AVE
GLENVIEW, IL 60025

Annual Reports
Report YearFiled Date
2004 03/09/2004
2005 07/18/2005
2006 11/07/2006