FORM 1023-EZ for BHA SUMMIT VILLAS SENIOR INC

Field Data
EIN 85-3385587
Case Number EO-2020295-000355
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BHA SUMMIT VILLAS SENIOR INC
Organization’s Mailing Address 621 W JEFFERSON STREET
City BROOKSVILLE
State FL
ZIP 34601-3500
Accounting period End 12
Primary contact name DONALD C SINGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONALD SINGER
EXECUTIVE DIRECTOR/SECRETARY
621 W JEFFERSON STREET
BROOKSVILLE FL 34601-3500

Officer/Director/Trustee Two

CLIFFORD MANUAL
PRESIDENT/DIRECTOR
621 W JEFFERSON STREET
BROOKSVILLE FL 34601-3500

Officer/Director/Trustee Three

FRANCINE WARD
VICE PRESIDENT/DIRECTOR
621 W JEFFERSON STREET
BROOKSVILLE FL 34601-3500

Officer/Director/Trustee Four

ERIC SANGVIC
DIRECTOR
621 W JEFFERSON STREET
BROOKSVILLE FL 34601-3500

Officer/Director/Trustee Five

GARY SCHRAUT
DIRECTOR
621 W JEFFERSON STREET
BROOKSVILLE FL 34601-3500

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/29/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L20 - Housing Development, Construction, Management
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 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 DONALD SINGER
Signature Title EXECUTIVE DIRECTOR/SECRETARY
Signature Date 10/12/2020

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