| Name: | INDIVIDUAL ASSURANCE COMPANY, LIFE, HEALTH & ACCIDENT |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Corporation |
| Status: | Conversion |
| Date of Organization in Rhode Island: | 04 May 2012 (13 years ago) |
| Date of Dissolution: | 13 Feb 2020 (5 years ago) |
| Date of Status Change: | 13 Feb 2020 (5 years ago) |
| Identification Number: | 000790085 |
| Place of Formation: | MISSOURI |
| Principal Address: | 930 E. 2ND STREETSUITE 100, EDMOND, OK, 73034, USA |
| Purpose: | LIFE INSURANCE COMPANY |
| NAICS: | 524113 - Direct Life Insurance Carriers |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 450 VETERANS MEMORIAL PARKWAY SUITE 7A, EAST PROVIDENCE, RI, 02914, USA |
| Name | Role | Address |
|---|---|---|
| DAVID W. BROOKS | PRESIDENT | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| Name | Role | Address |
|---|---|---|
| BRENT A. GIBSON | TREASURER | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| Name | Role | Address |
|---|---|---|
| M. RANDOLPH SPARKS | SECRETARY | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| Name | Role | Address |
|---|---|---|
| DARRELL W. DAVIS | VICE PRESIDENT | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| SCOTT E. DUMBAULD | VICE PRESIDENT | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| Name | Role | Address |
|---|---|---|
| TIM TACKETT | DIRECTOR | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| STEVEN R. HAGUE | DIRECTOR | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| NICOLE L. LIPPS | DIRECTOR | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| GARY R. PETERSON | DIRECTOR | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| GREGORY A. SCHAEFER | DIRECTOR | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| DAVID W. BROOKS | DIRECTOR | 930 E. 2ND STREET,SUITE 100 EDMOND, OK 73034 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Conversion | 2020-02-13 | INDIVIDUAL ASSURANCE COMPANY, LIFE, HEALTH & ACCIDENT | INDIVIDUAL ASSURANCE COMPANY, LIFE, HEALTH & ACCIDENT on 02-13-2020 |
| Number | Name | File Date |
|---|---|---|
| 202032582620 | Annual Report | 2020-01-18 |
| 201984639510 | Annual Report | 2019-01-17 |
| 201856610030 | Annual Report | 2018-01-23 |
| 201733683890 | Annual Report | 2017-02-07 |
| 201606037780 | Application for Amended Certificate of Authority | 2016-08-31 |
| 201606012930 | Annual Report | 2016-08-31 |
| 201606020980 | Annual Report | 2016-08-31 |
| 201606024870 | Annual Report | 2016-08-31 |
| 201606028490 | Annual Report | 2016-08-31 |
| 201605999610 | Reinstatement | 2016-08-31 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
