FORM 1023-EZ for ANTHEM OF GRACE

Field Data
EIN 84-4909414
Case Number EO-2020118-000356
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANTHEM OF GRACE
Organization’s Mailing Address PO BOX 213082
City ROYAL PALM BEACH
State FL
ZIP 33411
Accounting period End 12
Primary contact name BILL ETIENNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BILL ETIENNE
FOUNDER/CEO
PO BOX 213082
ROYAL PALM BEACH FL 33431

Officer/Director/Trustee Two

CATHLINE JOSEPH
PRESIDENT/SECRETARY
PO BOX 213082
ROYAL PALM BEACH FL 33411

Officer/Director/Trustee Three

RICHAMA JOSEPH
DIRECTOR
PO BOX 213082
ROYAL PALM BEACH FL 33411

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/18/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P60 - Emergency Assistance (Food, Clothing, Cash)
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: No
Scientific: No
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 No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 BILL ETIENNE
Signature Title FOUNDER/CEO
Signature Date 4/24/2020

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