FORM 1023-EZ for HEAVENAIRE CLUB BY GRACE LIVING HOME SERVICES INC

Field Data
EIN 81-5068815
Case Number EO-2017025-000221
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEAVENAIRE CLUB BY GRACE LIVING HOME SERVICES INC
Organization’s Mailing Address 7857 W SAMPLE ROAD STE 159
City CORAL SPRINGS
State FL
ZIP 33065-4748
Accounting period End 12
Primary contact name LORNA A DUKES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LORNA DUKES
CEO/PRESIDENT
10738 WEST SAMPLE ROAD
CORAL SPRINGS FL 33065-7419

Officer/Director/Trustee Two

DOMINIQUE PASCAL
CFO
10738 WEST SAMPLE ROAD
CORAL SPRINGS FL 33065-7419

Officer/Director/Trustee Three

ARIEL PASCAL
VP
10738 WEST SAMPLE ROAD
CORAL SPRINGS FL 33065-7419

Officer/Director/Trustee Four

CATTALEYA PASCAL
JVP
10738 WEST SAMPLE ROAD
CORAL SPRINGS FL 33065-7419

Organization’s website
Organization’s email LORNA@HEAVENAIRECLUB.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/12/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P50 - Personal Social Services
Organization’s purpose Charitable: Yes
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 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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