FORM 1023-EZ for OPTIMIST INTERNATIONAL

Field Data
EIN 59-6168871
Case Number EO-2014356-000476
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OPTIMIST INTERNATIONAL
Organization’s Mailing Address 16925 NW 25TH COURT
City MIAMI GARDENS
State FL
ZIP 33056
Accounting period End 12
Primary contact name NATACHA JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CANDACE HARPER
VP
2464 NW 135 STREET
MIAMI FL 33167

Officer/Director/Trustee Two

NATACHA PAYNE JONES
TREASURER
16925 NW 25TH COURT
MIAMI GARDENS FL 33056

Officer/Director/Trustee Three

LAMERCE JENKINS
P
691 W 22 STREET
HIALEAH FL 33010

Organization’s website
Organization’s email HIALEAHCOUGARSCHEER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/19/1963
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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