Detail by Officer/Registered Agent Name

Florida Limited Liability Company

JACQUES DAVIS ADULT FAMILY CARE HOME, LLC

Filing Information
L07000123799 N/A 12/13/2007 12/12/2007 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/25/2009 NONE
Principal Address
6746 MASSACHUSETTS DRIVE
LAKE WORTH, FL 33462

Changed: 06/04/2008
Mailing Address
6746 MASSACHUSETTS DRIVE
LAKE WORTH, FL 33462

Changed: 06/04/2008
Registered Agent Name & Address DAVIS, JACQUES A
6746 MASSACHUSETTS DRIVE
LAKE WORTH, FL 33462

Address Changed: 06/04/2008
Authorized Person(s) Detail Name & Address

Title MGR

DAVIS, CLOVER E
6748 RED REEF STREET
LAKE WORTH, FL 33467

Title MGR

DAVIS, JACQUES A
6748 RED REEF STREET
LAKE WORTH, FL 33467

Annual Reports
Report YearFiled Date
2008 09/02/2008