FORM 1023-EZ for THE GOOD SAMARITAN FOUNDATION INC

Field Data
EIN 35-2611635
Case Number EO-2018264-000340
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE GOOD SAMARITAN FOUNDATION INC
Organization’s Mailing Address 216 LAKE ARBOR DRIVE
City PALM SPRINGS
State FL
ZIP 33461
Accounting period End 12
Primary contact name DELVAR BENJAMIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DELVAR BENJAMIN
PRESIDENT
PO BOX 17248
WEST PALM BEACH FL 33416

Officer/Director/Trustee Two

ASTREL VINCENT
VICE PRESIDENT
PO BOX 17248
WEST PALM BEACHQ FL 33416

Officer/Director/Trustee Three

CARLENE BENJAMIN
SECRETARY
PO BOX 17428
WEST PALM BEACH FL 33416

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family 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 Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 DELVAR BENJAMIN
Signature Title PRESIDENT
Signature Date 9/19/18

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