FORM 1023-EZ for BLACK NURSES ROCK GAINESVILLE PALATKA CHAPTER
| Field | Data |
|---|---|
| EIN | 81-2484279 |
| Case Number | EO-2020231-000065 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BLACK NURSES ROCK GAINESVILLE PALATKA CHAPTER |
| Organization’s Mailing Address | 430 LAKESHORE DR |
| City | INTERLACHEN |
| State | FL |
| ZIP | 32148 |
| Accounting period End | 12 |
| Primary contact name | WHITNEY MILLER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
WHITNEY MILLER
TREASURER
700 FOREST GLEN DR APT 26
PALATKA FL 32177
Officer/Director/Trustee Two
DOLLICIA GREEN
PRESIDENT
430 LAKESHORE DR
INTERLACHEN FL 32148
Officer/Director/Trustee Three
ERIKA SHOWERS
VICE PRESIDENT
22980 NW 11TH RD
NEWBERRY FL 32669
Officer/Director/Trustee Four
MARCEA WILLIAMS
SECRETARY
430 LAKESHORES DR
INTERLACHEN FL 32148
Officer/Director/Trustee Five
KIZZY SHEPPARD MCCRAY
DIRECTOR OF COMMUNITY PARTNERSHIP
1588 NE 47TH PLACE
GAINESVILLE FL 32609
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/2/2016 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | W03 - Professional Societies, Associations |
| 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 | Yes |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | WHITNEY MILLER |
| Signature Title | TREASURER |
| Signature Date | 8/16/2020 |
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