Detail by Officer/Registered Agent Name

Florida Not For Profit Corporation

SAM'S HOUSE OF BROWARD, INC.

Filing Information
N04000004393 34-1993324 05/03/2004 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/15/2006 NONE
Principal Address
409 NW 29TH ST
WILTON MANORS, FL 33311
Mailing Address
409 NW 29TH ST
WILTON MANORS, FL 33311
Registered Agent Name & Address FARMER, BRIAN M
409 NW 29TH ST
WILTON MANORS, FL 33311
Officer/Director Detail Name & Address

Title CCEO

FARMER, BRIAN M
409 NW 29TH ST
WILTON MANORS, FL 33311

Title DCFO

FARMER, LORY A
409 NW 29TH ST
WILTON MANORS, FL 33311

Title S

HUGHES, DEBRA L
1218 SW 22 AVENUE
DELRAY BEACH, FL 33445

Title V

FERGUSON, DOREEN
4100 NW 35 AVENUE
LAUDERDALE LAKES, FL 33309

Title AVP

HONAKER, BRIAN P
1218 SW 22 AVENUE
DELRAY BEACH, FL 33445

Title D

FRANZEN, RUTH D
2225 NW 6 TERRACE
WILTON MANORS, FL 33311

Annual Reports
Report YearFiled Date
2005 03/04/2005