FORM 1023-EZ for INCLUSION WORKS INC

Field Data
EIN 83-1652108
Case Number EO-2018288-000651
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INCLUSION WORKS INC
Organization’s Mailing Address 6167 TALBOT ST
City NORTH PORT
State FL
ZIP 34287
Accounting period End 6
Primary contact name MARY ROBERTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY ROBERTS
PRESIDENT
6167 TALBOT ST
NORTH PORT FL 34287

Officer/Director/Trustee Two

SHAUNCEY BALDWIN
VICE PRESIDENT
920 ROSEAU WEST
VENICE FL 34285

Officer/Director/Trustee Three

KADINA HENDERSON
SECRETARY
4364 CHICOPA ST
NORTH PORT FL 34287

Officer/Director/Trustee Four

ERIC MATTESON
TREASURER
7528 PARRISH ST
NORTH PORT FL 34287

Officer/Director/Trustee Five

CARMEN THOMPSON
MEMBER
1904 ROSLYN AVE
BRADENTON FL 34207

Organization’s website
Organization’s email MROBERTS@INCLUSIONWORKSFL.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/26/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 Yes
Donation of funds Yes
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 No
Correctness Declaration Yes
Signature Name MARY ROBERTS
Signature Title PRESIDENT
Signature Date 10/13/18

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