FORM 1023-EZ for FORT MEADE DIXIE YOUTH INC

Field Data
EIN 81-1566610
Case Number EO-2016068-000163
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FORT MEADE DIXIE YOUTH INC
Organization’s Mailing Address 975 EDGEWOOD DRIVE
City FORT MEADE
State FL
ZIP 33841
Accounting period End 12
Primary contact name CLINTON CORNELIUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HENRY GRACE
DIRECTOR
P O BOX 781
FORT MEADE FL 33841

Officer/Director/Trustee Two

CLINTON CORNELIUS
PRESIDENT
720 ORANGE AVE N
FORT MEADE FL 33841

Officer/Director/Trustee Three

WILLIAM SHIVER
VICE PRESIDENT
2550 HWY 98 E
FORT MEADE FL 33841

Officer/Director/Trustee Four

LYNN SHIVER
SECRETARY/TREASURER
2550 HWY 98 E
FORT MEADE FL 33841

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/1969
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N63 - Baseball, Softball
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
Signature Title
Signature Date

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