FORM 1023-EZ for COMMUNITY HEALTH COALITION INC

Field Data
EIN 82-2527667
Case Number EO-2017289-000494
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY HEALTH COALITION INC
Organization’s Mailing Address 722 BROADWAY ST
City VERO BEACH
State FL
ZIP 32960
Accounting period End 12
Primary contact name RACHEL CLARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RACHEL CLARK
PRESIDENT
722 BROADWAY ST
VERO BEACH FL 32960

Officer/Director/Trustee Two

JOHN CLARK
VICE PRESIDENT
722 BROADWAY ST
VERO BEACH FL 32960

Officer/Director/Trustee Three

MARILYN MILLER
TREASURER
406 PISCATAWAY LN
HEDGESVILLE WV 25427

Officer/Director/Trustee Four

AUTUMN PAPPAS
SECRETARY
1348 HELLAS ST NW
PALM BAY FL 32907

Officer/Director/Trustee Five

KAREN WESTBERRY
MEDICAL ADVISOR
1200 AMETHYST DR SW
VERO BEACH FL 32968

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/4/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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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