Detail by Officer/Registered Agent Name

Florida Profit Corporation

COUNTRY CLUB INSURANCE GROUP, INC.

Filing Information
L75831 APPLIED FOR 05/25/1990 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 10/09/1992 NONE
Principal Address
POST OFFICE DRAWER 2412
DAYTONA BEACH, FL 32115-2412
Mailing Address
POST OFFICE DRAWER 2412
DAYTONA BEACH, FL 32115-2412
Registered Agent Name & Address PALMETTO CHARTER SERVICES, INC.
150 MAGNOLIA AVE.
DAYTONA BEACH, FL 32115-2491
Officer/Director Detail Name & Address

Title D

BROWN, J. HYATT
220 S. RIDGEWOOD AVE
DAYTONA BEACH, FL
Title D

HILL, KENNETH E.
220 S. RIDGEWOOD AVE
DAYTONA BEACH, FL
Title D

HENDERSON, JIM
220 S. RIDGEWOOD AVE
DAYTONA BEACH, FL
Title D

THOMAS, PETE
220 S. RIDGEWOOD AVE
DAYTONA BEACH, FL
Title PAN

KRATZ, RICHARD M.
220 S. RIDGEWOOD AVE
DAYTONA BEACH, FL
Annual Reports
Report YearFiled Date
1991 11/04/1991

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