Arizona Corporation Commission
07/31/2010 State of Arizona Public Access System 2:54 AM
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Corporate Inquiry
File Number: F-0994886-7
Corp. Name: PELATIS INSURANCE AGENCY CORP.
Domestic Address
3815 S WEST TEMPLE
ATTN: COMPLIANCE DEPT.
SALT LAKE CITY,  UT  84115-4412

Foreign Address
% CORPORATION SERVICE COMPANY
2338 W ROYAL PALM RD STE-J
PHOENIX,  AZ  85021

Statutory Agent Information
Agent Name:  CORPORATION SERVICE COMPANY
 
Agent Mailing/Physical Address:
2338 W ROYAL PALM RD STE-J
PHOENIX,  AZ  85021
 
Agent Status: APPOINTED 07/05/2001

Additional Corporate Information
Corporation Type: BUSINESS Business Type: PROVIDE LENDER PLACED HAZARD INSURANCE &
Incorporation Date:  07/05/2001 Corporate Life Period: PERPETUAL
Domicile:  UTAH County: MARICOPA
Approval Date:  07/05/2001 Original Publish Date:  07/23/2001

Officer Information 
JEFFREY W YOUNG
PRESIDENT
3815 S WEST TEMPLE
SALT LAKE CITY,UT  84115-4412
Date of Taking Office: 01/09/2008
Last Updated: 07/09/2010
JASON  H MILLER
SECRETARY
3815 S WEST TEMPLE
SALT LAKE CITY,UT  84115-4412
Date of Taking Office: 01/09/2008
Last Updated: 07/09/2010
JUSTIN CROWLEY
TREASURER
3815 S WEST TEMPLE
SALT LAKE CITY,UT  84115-4412
Date of Taking Office: 08/31/2009
Last Updated: 07/09/2010
JOLENE WISEMAN
VICE-PRESIDENT
3815 S WEST TEMPLE
SALT LAKE CITY ,UT  84115-4412
Date of Taking Office: 08/29/2005
Last Updated: 07/09/2010

Director Information 
JUSTIN CROWLEY
DIRECTOR
3815 S WEST TEMPLE
SALT LAKE CITY,UT  84115-4412
Date of Taking Office: 08/31/2009
Last Updated: 07/09/2010

TIMOTHY J O'BRIEN
DIRECTOR
3815 S WEST TEMPLE
SALT LAKE CITY,UT  84115-4412
Date of Taking Office: 01/09/2008
Last Updated: 07/09/2010

Annual Reports

Next Annual Report Due: 07/05/2011
File Year File Month Date Received Reason Returned Date Returned Extension
2010 07 06/03/2010      
2009 07 05/18/2009      
2008 07 05/09/2008      
2007 07 05/03/2007      
2006 07 06/20/2006      
2005 07 05/23/2005      
2004 07 08/18/2004      
2003 07 06/11/2003      
2002 07 05/30/2002      

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Scanned Documents
(Click on gray button to view document - will open in a new window)
Document Number Description Date Received
02 ANNUAL REPORT 05/30/2002
03 ANNUAL REPORT 06/11/2003
MULTIPLE CHANGES 08/25/2003
04 ANNUAL REPORT 08/18/2004
05 ANNUAL REPORT 05/23/2005
PUB OF APPL FOR NEW AUTHORITY 09/14/2005
06 ANNUAL REPORT 06/20/2006
07 ANNUAL REPORT 05/03/2007
08 ANNUAL REPORT 05/09/2008
09 ANNUAL REPORT 05/18/2009
10 ANNUAL REPORT 06/03/2010

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Amendments
Amendment Date Amendment Type Publish Date Publish Exception
05/12/2005 NAME CHANGE 09/14/2005      

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Name Changes / Mergers
Description Corporation Name Date
CHANGED FROM FAIRBANKS INSURANCE AGENCY CORP. 05/12/2005

Microfilm
Location Date Received Description
11475020015 07/05/2001 APPLICATION FOR AUTHORITY
20284016033 07/23/2001 PUB OF APPL FOR AUTHORITY
31667001592 05/30/2002 02 ANNUAL REPORT
31731001809 06/11/2003 03 ANNUAL REPORT
31745003621 08/25/2003 MULTIPLE CHANGES
31822001828 08/18/2004 04 ANNUAL REPORT
11722007021 05/12/2005 APPLICATION FOR NEW AUTHORITY
31883000293 05/23/2005 05 ANNUAL REPORT
31922001394 09/14/2005 PUB OF APPL FOR NEW AUTHORITY
31990000440 06/20/2006 06 ANNUAL REPORT
32053003195 05/03/2007 07 ANNUAL REPORT
32136000490 05/09/2008 08 ANNUAL REPORT

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