FORM 1023-EZ for TAMPA BAY ASTHMA COALITION

Field Data
EIN 47-4498229
Case Number EO-2015198-000336
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TAMPA BAY ASTHMA COALITION
Organization’s Mailing Address 11411 CARROLLWOOD DRIVE
City TAMPA
State FL
ZIP 33618
Accounting period End 7
Primary contact name MARY MARTINASEK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CYNTHIA KEETON
PRESIDENT
6241 OAK CLUSTER CIRCLE
TAMPA FL 33624

Officer/Director/Trustee Two

VECELIA JOHNSON
VICE PRESIDENT
9309 BIANCA COURT
RIVERVIEW FL 33578

Officer/Director/Trustee Three

BRENDA MOUNT
SECRETARY
933 GRAND CANYON DRIVE
VALRICO FL 33594

Officer/Director/Trustee Four

LASHUNE HARRIS
ASSISTANT SECRETARY
11813 NEWBERRY GROVE LOOP
RIVERVIEW FL 33579

Officer/Director/Trustee Five

MARY MARTINASEK
TREASURER
11411 CARROLLWOOD DRIVE
TAMPA FL 33618

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 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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