FORM 1023-EZ for JAZZ ON MOORES CREEK INC

Field Data
EIN 47-1322185
Case Number EO-2017132-000245
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JAZZ ON MOORES CREEK INC
Organization’s Mailing Address 1234 AVENUE D
City FORT PIERCE
State FL
ZIP 34950
Accounting period End 9
Primary contact name PAMELA CARITHERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUELYNNE LEWIS
PRESIDENT
709 AVENUE B
FORT PIERCE FL 34950

Officer/Director/Trustee Two

PEGGY HARRIS
VICE PRESIDENT
2702 AVENUE I
FORT PIERCE FL 34950

Officer/Director/Trustee Three

BENNIE CLARK SR
SECRETARY/TREASURER
1812 AVENUE M
FORT PIERCE FL 34950

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/3/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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