FORM 1023-EZ for SHANTERIA ELISA GOURDET

Field Data
EIN 82-3711477
Case Number EO-2018052-000181
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHANTERIA ELISA GOURDET
Organization’s Mailing Address 7415 NW 44TH STREET APT 1415
City LAUDERHILL
State FL
ZIP 33319
Accounting period End 12
Primary contact name SHANTERIA GOURDET
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANTERIA GOURDET
PRESIDENT
7415 NW 44TH STREET APT 1415
LAUDERHILL FL 33319

Officer/Director/Trustee Two

DIANE CHUKURAH
TREASURER
13720 NW 22ND AVE
OPA LOCKA FL 33054

Officer/Director/Trustee Three

MARILYN WILLIAMS
DIRECTOR/SEC
16269 SW 16TH STREET
PEMBROKE PINES FL 33027

Officer/Director/Trustee Four

ELIZABETH SCOTT
DIRECTOR
8263 NW 5TH COURT
MIAMI FL 33150

Officer/Director/Trustee Five

MILLENCE WILLIAMS
DIRECTOR
16269 SOUTHWEST 16TH AVE
MIAMI FL 33027

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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 SHANTERIA GOURDET
Signature Title PRESIDENT
Signature Date 2/19/18

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