FORM 1023-EZ for IMPACT COMMUNITY CENTER INC

Field Data
EIN 85-1101808
Case Number EO-2020258-000608
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name IMPACT COMMUNITY CENTER INC
Organization’s Mailing Address 3631 MINNESOTA DRIVE
City FORT MYERS
State FL
ZIP 33916
Accounting period End 12
Primary contact name 2398396834
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KERI JEWETT-GILES
OWNER
3631 MINNESOTA DRIVE
FORT MYERS FL 33916

Officer/Director/Trustee Two

GAYNELL BLAND
VICE PRESIDENT
770 CAYCE LANE
FORT MYERS FL 33905

Officer/Director/Trustee Three

DEMESHA GILES
SECRETARY/TREASURER
3631 MINNESOTA DRIVE
FORT MYERS FL 33916

Organization’s website
Organization’s email KERI.JEWETT3@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: Yes
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 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 KERI JEWETT-GILES
Signature Title OWNER
Signature Date 9/11/2020

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