{"entity":{"id":12745438,"state":"FL","state_id":"812086","entity_name":"JEFFERSON NATIONAL LIFE INSURANCE COMPANY","entity_type":"FORP","entity_type_normalized":"foreign_profit","status":"I","filing_date":"1957-10-01","filing_year":1957,"business_age_years":69,"principal_address1":"C/O GREAT AMERICAN RESERVE INSURANCE CO.","principal_address2":"11815 N. PENNSYLVANIA ST.","principal_city":"CARMEL","principal_state":"IN","principal_zip":"46032-4572","principal_country":"","mail_address1":"C/O GREAT AMERICAN RESERVE INSURANCE CO.","mail_address2":"11815 N. PENNSYLVANIA ST.","mail_city":"CARMEL","mail_state":"IN","mail_zip":"46032-4572","mail_country":"","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"350421411","jurisdiction":null,"county":null,"last_transaction_date":"03091995","report_year_1":"1994","report_date_1":"04261994","report_year_2":"1994","report_date_2":"04261994","report_year_3":"1993","report_date_3":"05011993","agent_name":"Financial Officer Chief","agent_type":"C","agent_address":"P O BOX 6200 (32314-6200)","agent_city":"TALLAHASSEE","agent_state":"FL","agent_zip":"323990000","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata6.txt","fetched_at":"2026-05-09 14:06:26","updated_at":"2026-05-09 14:06:26","last_accessed":null,"status_reason":null,"agent_name_raw":"CHIEF FINANCIAL OFFICER"},"officers":[{"name":"James S, Adams","first_name":"James","last_name":"Adams","title":"Vice President, Treasurer","title_roles":["Vice President","Treasurer"],"title_code":"vt","is_registered_agent":false,"address":"11815 N PENNSYLVANIA ST","city":"CARMEL, INC.","state":"","zip":"","name_raw":"ADAMS, JAMES S,"},{"name":"Rollin M. Dick","first_name":"Rollin","last_name":"Dick","title":"Vice President, Director","title_roles":["Vice President","Director"],"title_code":"vd","is_registered_agent":false,"address":"11815 N PENNSYLVANIA ST","city":"CARMEL","state":"IN","zip":"","name_raw":"DICK, ROLLIN M."},{"name":"Donald Gongaware","first_name":"Donald","last_name":"Gongaware","title":"Vice President, Director","title_roles":["Vice President","Director"],"title_code":"vd","is_registered_agent":false,"address":"11815 N.PENNSYLVANIA ST.","city":"CARMEL","state":"IN","zip":"46032","name_raw":"GONGAWARE           DONALD"},{"name":"Stephen C. Hilbert","first_name":"Stephen","last_name":"Hilbert","title":"Chairman, Director","title_roles":["Chairman","Director"],"title_code":"cd","is_registered_agent":false,"address":"11815 N. PENNSYLVANIA ST","city":"CARMEL","state":"IN","zip":"","name_raw":"HILBERT, STEPHEN C."},{"name":"Lawrence W. Inlow","first_name":"Lawrence","last_name":"Inlow","title":"Vice President, Secretary, Director","title_roles":["Vice President","Secretary","Director"],"title_code":"vsd","is_registered_agent":false,"address":"11815 N PENNSYLVANIA ST","city":"CARMEL","state":"IN","zip":"","name_raw":"INLOW, LAWRENCE W."},{"name":"Lynn C. Tyson","first_name":"Lynn","last_name":"Tyson","title":"President, Director","title_roles":["President","Director"],"title_code":"pd","is_registered_agent":false,"address":"11815 N. PENNSYLVANIA ST","city":"CARMEL","state":"IN","zip":"46032","name_raw":"TYSON, LYNN C."}],"filing_history":[],"status_history":[],"unknown":["status_history: we do not collect status-change histories from the source feeds, so this empty list means we hold none — NOT that this company's status has never changed. Observed changes we DID see are under `history`."],"verified_domains":[],"history":null,"web_contact":null,"provenance_url":"https://private.rootz.global/api/provenance/FL/812086"}