2019 FLORIDA NOT FOR PROFIT CORPORATION ANNUAL REPORT FILED

DOCUMENT# 705136 Jan 15, 2019

Entity Name: FLORIDA 4-H CLUB FOUNDATION, INC. Secretary of State
9519324591CC
Current Principal Place of Business:
1604 MCCARTY DR. RM 1040
UNIVERSITY OF FLORIDA
GAINESVILLE, FL 32611

Current Mailing Address:

PO BOX 110225
GAINESVILLE, FL 32611-0225 US

FEI Number: 59-1000186 Certificate of Status Desired: No

Name and Address of Current Registered Agent:
PLACE, NICK
1604 MCCARTY DR. RM 1040
UNIVERSITY OF FLORIDA
GAINESVILLE, FL 32611 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: NICK PLACE 01/15/2019

Electronic Signature of Registered Agent Date

Officer/Director Detail :
Title PRESIDENT Title CEO
Name WILLIAMS, ROBERT Name PLACE, NICK
Address 7007 KATIE ASHLEE CT. Address 1604 MCCARTY DR. RM 1040
UNIVERSITY OF FLORIDA
City-State-Zip: TALLAHASEE FL 32309
City-State-Zip: GAINESVILLE FL 32611

Title PRESIDENT ELECT

Title VP
Name ELLIS, WHITNEY
Name WICKERSHEIM, MICHAEL
Address 1898 TURNBERRY TERRACE
Address 1904 MICCOSUKEE RD
City-State-Zip: ORLANDO FL 32804
City-State-Zip: TALLAHASSEE FL 32308

Title VP
Title COMPTROLLER
Name DAILY, VALERIE
Name HARTMAN, KATHRYN
Address 5780 SW 20TH STREET
Address 1604 MCCARTY DR. RM 1040
City-State-Zip: OCALA FL 34474 UNIVERSITY OF FLORIDA
City-State-Zip: GAINESVILLE FL 32611
Title SECRETARY
Name ALLEN, MENDY
Address 12271 JERNIGAN AVENUE
City-State-Zip: CEDAR KEY FL 32625

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: KATHRYN HARTMAN COMPTROLLER 01/15/2019

Electronic Signature of Signing Officer/Director Detail Date