FORM 1023-EZ for INTERNATIONAL CENTER 4 YOUTH SERVICES

Field Data
EIN 27-1542514
Case Number EO-2016193-000209
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INTERNATIONAL CENTER 4 YOUTH SERVICES
Organization’s Mailing Address 7777 GLADES ROAD SUITE 100
City BOCA RATON
State FL
ZIP 33434
Accounting period End 1
Primary contact name MATHIEU DAQUIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID KELLY
DIRECTOR
7777 WEST GLADES ROAD SUITE 100
BOCA RATON FL

Officer/Director/Trustee Two

CARLOS DIAZ
SECRETARY
7777 WEST GLADES ROAD SUITE 100
BOCA RATON FL

Officer/Director/Trustee Three

LUCY JOHNS
TREASURER
7777 WEST GLADES ROAD SUITE 100
BOCA RATON FL

Officer/Director/Trustee Four

JAMES GRIFFIN
DIRECTOR
7777 WEST GLADES ROAD SUITE 100
BOCA RATON FL

Officer/Director/Trustee Five

KEVIN SAWYER
VICE -PRESIDENT
7777 WEST GLADES ROAD SUITE 100
BOCA RATON FL

Organization’s website
Organization’s email IC4YM@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/21/2011
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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