FORM 1023-EZ for SENIOR CHAMPIONS FELLOWSHIP HALL

Field Data
EIN 85-0652826
Case Number EO-2020104-000315
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SENIOR CHAMPIONS FELLOWSHIP HALL
Organization’s Mailing Address PO BOX 2228
City KEYSTONE HEIGHTS
State FL
ZIP 32656
Accounting period End 12
Primary contact name KATHIE MONROE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MYRA LEWIS
PRESIDENT
205 SW MAGNOLIA AVE
KEYSTONE HEIGHTS FL 32656

Officer/Director/Trustee Two

JAMES PERRY
VICE PRESIDENT
205 SW MAGNOLIA AVE
KEYSTONE HEIGHTS FL 32656

Officer/Director/Trustee Three

KATHIE MONROE
SEC/TREASURER
205 SW MAGNOLIA AVE
KEYSTONE HEIGHTS FL 32656

Officer/Director/Trustee Four

DOLLIE GLISSON
DIRECTOR
205 SW MAGNOLIA AVE
KEYSTONE HEIGHTS FL 32656

Officer/Director/Trustee Five

KITTY WILLIS
DIRECTOR
205 SW MAGNOLIA AVE
KEYSTONE HEIGHTS FL 32656

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/16/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KATHIE MONROE
Signature Title SEC/TREASURER
Signature Date 4/10/2020

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