FORM 1023-EZ for INTERRACIAL ASSOCIATION TO SAVE A LIFE INC

Field Data
EIN 81-2475439
Case Number EO-2019284-000143
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INTERRACIAL ASSOCIATION TO SAVE A LIFE INC
Organization’s Mailing Address 933 LEE ROAD SUITE 325
City ORLANDO
State FL
ZIP 32810
Accounting period End 12
Primary contact name MARIE JEAN GILLES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARIE JEAN GILLES
PRESIDENT
933 LEE RD SUITE 325
ORLANDO FL 32810

Officer/Director/Trustee Two

PAUL VALCIMON
VICE-PRESIDENT
933 LEE RD SUITE 325
ORLANDO FL 32810

Officer/Director/Trustee Three

PHYLLIS HUTTO
SECRETARY
933 LEE RD SUITE 325
ORLANDO FL 32810

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: No
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: Yes
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 MARIE JEAN GILLES
Signature Title PRESIDENT
Signature Date 10/7/2019
EIN 81-2475439
Case Number EO-2016221-000038
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INTERRACIAL ASSOCIATION TO SAVE A LIFE INC
Organization’s Mailing Address 933 LEE ROAD SUITE 325
City ORLANDO
State FL
ZIP 32810
Accounting period End 12
Primary contact name MARIE JEAN-GILLES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARIE JEAN-GILLES
PRESIDENT
933 LEE ROAD SUITE 325
ORLANDO FL 32810

Officer/Director/Trustee Two

PAUL VALCIMON
VICE PRESIDENT
933 LEE ROAD SUITE 325
ORLANDO FL 32810

Officer/Director/Trustee Three

PHYLLIS HUTTO
SECRETARY
933 LEE ROAD SUITE 325
ORLANDO FL 32810

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/27/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
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 No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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