FORM 1023-EZ for SCLC OF JACKSONVILLE FLORIDA INC

Field Data
EIN 81-3976447
Case Number EO-2016273-000432
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SCLC OF JACKSONVILLE FLORIDA INC
Organization’s Mailing Address 903 UNION STREET WEST
City JACKSONVILLE
State FL
ZIP 32204
Accounting period End 12
Primary contact name LARRY H GWYN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUAN GRAY
CHAIRMAN
2791 TAYLOR HILL DR
JACKSONVILLE FL 32221

Officer/Director/Trustee Two

LEVY WILCOX
PRESIDENT
6804 BOGATA DR
JACKSONVILLE FL 32210

Officer/Director/Trustee Three

TOMMY ROGERS
VICE PRESIDENT
9652 ABERDARE AVE W
JACKSONVILLE FL 32208

Officer/Director/Trustee Four

LARRY GWYN
TREASURER
11663 STONEBRIDGE DR N
JACKSONVILLE FL 32223

Officer/Director/Trustee Five

ROSA CARTER
SECRETARY
4446 HENDRICKS AVE 256
JACKSONVILLE FL 32207

Organization’s website SCLCJAXFL.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/30/2013
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R60 - Civil Liberties Advocacy
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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