FORM 1023-EZ for JILLIANS LOCKER INC

Field Data
EIN 84-2639960
Case Number EO-2019226-000338
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JILLIANS LOCKER INC
Organization’s Mailing Address 695 SW SALERNO RD
City STUART
State FL
ZIP 34997
Accounting period End 12
Primary contact name PATRICIA COOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA COOK
PRESIDENT, DIRECTOR
695 SW SALERNO RD
STUART FL 34997

Officer/Director/Trustee Two

RICHARD COOK
TREASURER, DIRECTOR
695 SW SALERNO RD
STUART FL 34997

Officer/Director/Trustee Three

ERIN WARREN
SECRETARY, DIRECTOR
695 SW SALERNO RD
STUART FL 34997

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/8/19
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: 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 Yes
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 PATRICIA COOK
Signature Title PRESIDENT, DIRECTOR
Signature Date 8/12/19

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