FORM 1023-EZ for CHAMPION CARES INC

Field Data
EIN 84-2703218
Case Number EO-2020177-000664
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHAMPION CARES INC
Organization’s Mailing Address 3355 MILLCREST DR
City JACKSONVILLE
State FL
ZIP 32277
Accounting period End 12
Primary contact name DANIQUE DOUGLAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARREN MASON
DIRECTOR
3355 MILLCREST DR
JACKSONVILLE FL 32277

Officer/Director/Trustee Two

WHITNEY MURRAY-BROWN
D
1521 MILLBROOK COURT
FLEMING ISLAND FL 32003

Officer/Director/Trustee Three

BRENDA TITUS
D
4936 TOP ROYAL LN
JACKSONVILLE FL 32277

Officer/Director/Trustee Four

LATRENA THOMAS
D
7970 CONCORD BLVD W
JACKSONVILLE FL 32208

Officer/Director/Trustee Five

ASHA JALEEL
D
3587 HIGHLAND GLEN WAY W
JACKSONVILLE FL 32224

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P50 - Personal Social Services
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 DARREN MASON
Signature Title DIRECTOR
Signature Date 6/23/2020

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