{"entity":{"id":15879604,"state":"FL","state_id":"M90389","entity_name":"FORM STORES OF AMERICA, INC.","entity_type":"DOMP","entity_type_normalized":"domestic_profit","status":"I","filing_date":"1988-07-15","filing_year":1988,"business_age_years":38,"principal_address1":"605 7TH AVE. N.","principal_address2":"UNIT D","principal_city":"SAFETY HARBOR","principal_state":"FL","principal_zip":"34695","principal_country":"US","mail_address1":"P. O. BOX 27","mail_address2":"","mail_city":"SAFETY HARBOR","mail_state":"FL","mail_zip":"34695","mail_country":"US","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"592899931","jurisdiction":null,"county":null,"last_transaction_date":"10161998","report_year_1":"1997","report_date_1":"03211997","report_year_2":"1997","report_date_2":"03211997","report_year_3":"1996","report_date_3":"05011996","agent_name":"Louis Albano","agent_type":"P","agent_address":"605 7TH AVENUE NORTH","agent_city":"SAFETY HARBOR","agent_state":"FL","agent_zip":"34695","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata9.txt","fetched_at":"2026-05-09 15:54:16","updated_at":"2026-05-09 15:54:16","last_accessed":null,"status_reason":null,"agent_name_raw":"ALBANO              LOUIS"},"officers":[{"name":"Louis Albano","first_name":"Louis","last_name":"Albano","title":"Vice President, Secretary, Treasurer, Director","title_roles":["Vice President","Secretary","Treasurer","Director"],"title_code":"vstd","is_registered_agent":false,"address":"708 MADERA AVE","city":"CLEARWATER","state":"FL","zip":"","name_raw":"ALBANO, LOUIS"},{"name":"Carl Gallo","first_name":"Carl","last_name":"Gallo","title":"President, Director","title_roles":["President","Director"],"title_code":"pd","is_registered_agent":false,"address":"P O BOX 1938 N/A","city":"MIAMI","state":"FL","zip":"","name_raw":"GALLO, CARL"}],"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/M90389"}