FORM 1023-EZ for LAKE ROUSSEAU WATERKEEPER CORP

Field Data
EIN 84-2274271
Case Number EO-2019193-000121
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAKE ROUSSEAU WATERKEEPER CORP
Organization’s Mailing Address 81 KAREN ST
City INGLIS
State FL
ZIP 34449
Accounting period End 12
Primary contact name NINON ROY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NINON ROY
PRESIDENT
81 KAREN ST
INGLIS FL 34449

Officer/Director/Trustee Two

ROBERT VARNER
VP
81 KAREN ST
INGLIS FL 34449

Officer/Director/Trustee Three

CEDIC BOURGEOIS
ADM
81 KAREN ST
INGLIS FL 34449

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C30 - Natural Resources Conservation and Protection
Organization’s purpose Charitable: No
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 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 NINON ROY
Signature Title PRESIDENT
Signature Date 7/10/19

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