FORM 1023-EZ for EDMUND CHENEY SJ FOUNDATION INC

Field Data
EIN 81-5447733
Case Number EO-2020051-000103
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EDMUND CHENEY SJ FOUNDATION INC
Organization’s Mailing Address 9481 ENCINO STREET
City MIRAMAR
State FL
ZIP 33025
Accounting period End 12
Primary contact name CLAUDIA FORRETST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTHONY DACOSTA
PRESIDENT
490 PINE AVENUE UNIT 408P
LONG BEACH CA 90802

Officer/Director/Trustee Two

MICHAEL CAMPBELL
TREASURER
7219 LYNDHAM HILL CIR
LORTON VA 22079

Officer/Director/Trustee Three

CLAUDIA FORREST
SECRETARY
9481 ENCINO STREET
MIRAMAR FL 33025

Officer/Director/Trustee Four

KEVAN DARBY
DIRECTOR
39 POPE HILL ROAD
MILTON MA 02186

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/20/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B84 - Alumni Associations
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 Yes
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 CLAUDIA FORREST
Signature Title SECRETARY
Signature Date 2/15/2020

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