{"entity":{"id":11017527,"state":"FL","state_id":"N11000003365","entity_name":"USA/CANADA LIONS LEADERSHIP FORUM TAMPA BAY, INC","entity_type":"DOMNP","entity_type_normalized":"domestic_nonprofit","status":"I","filing_date":"2011-04-04","filing_year":2011,"business_age_years":15,"principal_address1":"2916 CLOVERFIELD LANE","principal_address2":"","principal_city":"VALRICO","principal_state":"FL","principal_zip":"33596","principal_country":"US","mail_address1":"2916 CLOVERFIELD LANE","mail_address2":"","mail_city":"VALRICO","mail_state":"FL","mail_zip":"33596","mail_country":"US","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"274327928","jurisdiction":null,"county":null,"last_transaction_date":"09272013","report_year_1":"2012","report_date_1":"02082012","report_year_2":"2012","report_date_2":"02082012","report_year_3":"","report_date_3":"","agent_name":"Jacqueline B Cameron","agent_type":"P","agent_address":"2916 CLOVERFIELD LANE","agent_city":"VALRICO","agent_state":"FL","agent_zip":"33596","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata5.txt","fetched_at":"2026-05-09 12:50:41","updated_at":"2026-05-09 12:50:41","last_accessed":null,"status_reason":null,"agent_name_raw":"CAMERON             JACQUELINE    B"},"officers":[{"name":"Jacqueline B Cameron","first_name":"Jacqueline","last_name":"Cameron","title":"President","title_roles":["President"],"title_code":"president","is_registered_agent":true,"address":"2916 CLOVERFIELD LANE","city":"VALRICO","state":"FL","zip":"33596","name_raw":"CAMERON             JACQUELINE    B"},{"name":"John Carbaugh","first_name":"John","last_name":"Carbaugh","title":"Vice President","title_roles":["Vice President"],"title_code":"vp","is_registered_agent":false,"address":"2412 WALLACE ROAD","city":"LUTZ","state":"FL","zip":"33549","name_raw":"CARBAUGH            JOHN"},{"name":"C David Lloyd","first_name":"C","last_name":"Lloyd","title":"Secretary","title_roles":["Secretary"],"title_code":"sec","is_registered_agent":false,"address":"4330 COLLINGTREE DRIVE","city":"ROCKLEDGE","state":"FL","zip":"32955","name_raw":"LLOYD               C DAVID"},{"name":"Paul Nash","first_name":"Paul","last_name":"Nash","title":"Treasurer","title_roles":["Treasurer"],"title_code":"tres","is_registered_agent":false,"address":"19124 GRENELEFE COURT","city":"NORTH FORT MYERS","state":"FL","zip":"33903","name_raw":"NASH                PAUL"},{"name":"Gary Nieskes","first_name":"Gary","last_name":"Nieskes","title":"Manager","title_roles":["Manager"],"title_code":"manager","is_registered_agent":false,"address":"57 WINDSOR DRIVE","city":"ENGLEWOOD","state":"FL","zip":"34223","name_raw":"NIESKES             GARY"}],"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/N11000003365"}