FORM 1023-EZ for POLISH AMERICAN SOCIAL CLUB OF VEROBEACH FLORIDA USA INC

Field Data
EIN 81-1036537
Case Number EO-2018107-000214
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name POLISH AMERICAN SOCIAL CLUB OF VEROBEACH FLORIDA USA INC
Organization’s Mailing Address 40 43RD AVENUE
City VERO BEACH
State FL
ZIP 32968-2305
Accounting period End 12
Primary contact name GLORIA FLEMING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JERRY CYGLER
PRESIDENT
1415 CORONA LANE
VERO BEACH FL 32963-2508

Officer/Director/Trustee Two

RON ROZ
VICE PRESIENT
P O BOX 281
EAST ANDOVER NH 3231-281

Officer/Director/Trustee Three

KEN DALE
TREASURER
6195 55TH AVENUE
VERO BEACH FL 32967-6438

Officer/Director/Trustee Four

GLORIA FLEMING
DIRECTOR
9936 OAK STREET
SEBASTIAN FL 32976-3115

Officer/Director/Trustee Five

TOMEK CLARK
DIRECTOR
P O BOX 1723
VERO BEACH FL 32961-1723

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/16
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name GLORIA FLEMING
Signature Title DIRECTOR
Signature Date 3/23/18

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