Entity Name: 4108 Aerie Immokalee, Fraternal Order of Eagles
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GlendaEntity Name: 4108 Aerie Immokalee, Fraternal Order of Eagles
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Glenda2021 FLORIDA NOT FOR PROFIT CORPORATION ANNUAL REPORT FILED
DOCUMENT# N14292 Feb 03, 2021
Entity Name: 4108 AERIE IMMOKALEE, FRATERNAL ORDER OF EAGLES, Secretary of State
INC. 6832760958CC
Current Principal Place of Business:
403 W NEW MARKET RD
IMMOKALEE, FL 34142
Current Mailing Address:
P.O.BOX 5063
IMMOKALEE, FL 34143
FEI Number: 59-2528160 Certificate of Status Desired: Yes
Name and Address of Current Registered Agent:
BURNHAM, ANTOINETTE
396 JOHN JIMMIE BLVD
IMMOKALEE, FL 34142 US
The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida.
SIGNATURE: ANTOINETTE BURNHAM 02/03/2021
Electronic Signature of Registered Agent Date
Officer/Director Detail :
Title S Title PRESIDENT
Name RICE, STEPHANIE Name BURNHAM, ANTOINETTE
Address 1104 N 11TH ST Address 396 JOHN JIMMIE BLVD
City-State-Zip: IMMOKALEE FL 34142 City-State-Zip: IMMOKALEE FL 34142
I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under
oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617, Florida Statutes; and that my name appears
above, or on an attachment with all other like empowered.
SIGNATURE: ANTOINETTE BURNHAM PRESIDENT 02/03/2021
Electronic Signature of Signing Officer/Director Detail Date
