FORM 1023-EZ for FLORIDA STREET HOUSE INC

Field Data
EIN 82-1577146
Case Number EO-2017142-000379
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FLORIDA STREET HOUSE INC
Organization’s Mailing Address 4002 OAKCLIFFE ROAD
City GREENSBORO
State NC
ZIP 27406
Accounting period End 12
Primary contact name GENE LEDBETTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GENE LEDBETTER
DIRECTOR
4002 OAKCLIFFE ROAD
GREENSBORO NC 27406

Officer/Director/Trustee Two

GAIL LEDBETTER
BOARD OF DIRECTORS
4002 OAKCLIFFE ROAD
GREENSBORO NC 27406

Officer/Director/Trustee Three

WINFRED GALLIMORE
BOARD OF DIRECTORS
4606 BRANTHURST DRIVE
GREENSBORO NC 27407

Officer/Director/Trustee Four

SUSAN BOZOVICH
BOARD OF DIRECTORS
237 HOMEPLACE DRIVE
RANDLEMAN NC 27317

Officer/Director/Trustee Five

NAVELYN MCNEAL
BOARD OF DIRECTORS
1113 PORTLAND STREET
GREENSBORO NC 27403

Organization’s website WWW.FLORIDASTREETHOUSE.ORG
Organization’s email FLORIDASTREETHOUSE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/12/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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
Signature Title
Signature Date

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