FORM 1023-EZ for AUTISM BOX OF LOVE CORPORATION

Field Data
EIN 47-2625248
Case Number EO-2015061-000282
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AUTISM BOX OF LOVE CORPORATION
Organization’s Mailing Address 3936 S SEMORAN BLVD SUITE 272
City ORLANDO
State FL
ZIP 32822
Accounting period End 12
Primary contact name AYAMI CHIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AYAMI CHIN
PRESIDENT
3936 S SEMORAN BLVD SUITE 272
ORLANDO FL 32822

Officer/Director/Trustee Two

THERESA SHOCKLEY
VICE PRESIDENT
4850 FAYANN ST
ORLANDO FL 32812

Officer/Director/Trustee Three

CHRIS MASON
SECRETARY/TREASURER
4417 13TH ST SUITE 118
ST CLOUD FL 34769

Officer/Director/Trustee Four

CRAIG CONWAY
BOARD MEMBER
10766 SAVANNAH WOOD COURT
ORLANDO FL 32832

Organization’s website WWW.AUTISMBOXOFLOVE.ORG
Organization’s email INFO@AUTISMBOXOFLOVE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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