FORM 1023-EZ for PINE HILLS SENIORS INC

Field Data
EIN 47-5150602
Case Number EO-2015278-000411
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PINE HILLS SENIORS INC
Organization’s Mailing Address 6408 JENNINGS RD
City ORLANDO
State FL
ZIP 32818
Accounting period End 12
Primary contact name SHEILA BELLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHEILA BELLE
PRESIDENT
7202 REX HILL TRAIL
ORLANDO FL 32818

Officer/Director/Trustee Two

BERTINA BUSCH
VICE PRESIDENT
6012 BEAU LANE
ORLANDO FL 32808

Officer/Director/Trustee Three

EDDIE BROWN
TREASURER
1284 FOX FORREST CIRCLE
APOPKA FL 32712

Officer/Director/Trustee Four

ONA TAYLOR
SECRETARY
3309 BEAZER DR
OCOEE FL 34761

Officer/Director/Trustee Five

CONRAD TAYLOR
MEMBER
3309 BEAZER DR
OCOEE FL 34761

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 Yes
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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