FORM 1023-EZ for JAXCC - JACKSONVILLE CHESS CLUB

Field Data
EIN 81-5187620
Case Number EO-2017054-000237
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JAXCC - JACKSONVILLE CHESS CLUB
Organization’s Mailing Address 7643 GATE PARKWAY104-16
City JACKSONVILLE
State FL
ZIP 32256
Accounting period End 12
Primary contact name SCOTT CAVAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN PRYOR
PRESIDENT
8694 ETHANS GLEN TERRACE
JACKSONVILLE FL 32256

Officer/Director/Trustee Two

SCOTT CAVAN
TREASURE
11432 CHASE MEADOWS DR N
JACKSONVILLE FL 32256

Officer/Director/Trustee Three

CARMEN ROJAS
SECRATARY
13706 FISH EAGLE DR W
JACKSONVILLE FL 32226

Officer/Director/Trustee Four

AMY KOPPE
VICE PRESIDENT
1006 FRUIT COVE RD
JACKSONVIILE FL 32259

Officer/Director/Trustee Five

COREY KOSCIUSZKO
BOARD OF DIRECTOR
13100 BROXTON BAY DRIVE
JACKSONVILLE FL 32218

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: No
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 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
Signature Title
Signature Date

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