Detail by Officer/Registered Agent Name

Florida Not For Profit Corporation

THE NICOLE FOUNDATION OF THE MENTAL HEALTH CENTER OF JACKSONVILLE, INC.

Filing Information
N93000004861 59-3208890 10/25/1993 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 10/04/2002 NONE
Principal Address
900 UNIVERSITY BLVD
STE 700
JACKSONVILLE, FL 32211

Changed: 04/29/1999
Mailing Address
P O BOX 19189
JACKSONVILLE, FL 32245

Changed: 04/29/1999
Registered Agent Name & Address SIKORA, GREGORY J
900 UNIVERSITY BLVD
STE 700
JACKSONVILLE, FL 32211

Address Changed: 04/29/1999
Officer/Director Detail Name & Address

Title CD

GREGORY, E.C.
12874 DUNES CT
JACKSONVILLE, FL 32225

Title VCD

FLAGG, EUGENE
4271 MCDANIEL DR
JACKSONVILLE, FL

Title SD

LECLERC, DONALD
236 HOLLY COURT
JACKSONVILLE, FL

Title TD

LEWIS, CHARLES W.
5307 FLEET LANDING BLVD.
ATLANTIC BEACH, FL

Title P

SIKORA, GREGORY
900 UNIVERSITY BLVD N STE 700
JACKSONVILLE, FL 32211

Annual Reports
Report YearFiled Date
1999 04/29/1999
2000 03/21/2000
2001 02/20/2001