FORM 1023-EZ for BLUE EYED ANGELS SHOWERED AND EMPOWERED

Field Data
EIN 82-5065210
Case Number EO-2018100-000070
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLUE EYED ANGELS SHOWERED AND EMPOWERED
Organization’s Mailing Address 312 NORTH HOLLYWOOD AVE
City DAYTONA BEACH
State FL
ZIP 32118
Accounting period End 3
Primary contact name BARBARA BURNES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BARBARA BURNES
P
312 NORTH HOLLYWOOD AVE
DAYTONA BEACH FL 32118

Officer/Director/Trustee Two

GEORGE CAFFERY
VP
312 NORTH HOLLYWOOD AVE
DAYTONA BEACH FL 32118

Officer/Director/Trustee Three

REBA ANDERSON
SEC
312 NORTH WILD OLIVE
DAYTONA BEACH FL 32118

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BARBARA BURNES
Signature Title P
Signature Date 4/5/18

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