FORM 1023-EZ for ACCESS WORSHIP INTERNATIONAL INC

Field Data
EIN 82-1876180
Case Number EO-2020274-000137
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ACCESS WORSHIP INTERNATIONAL INC
Organization’s Mailing Address 2701 HODGES BLVD
City JACKSONVILLE
State FL
ZIP 32224
Accounting period End 12
Primary contact name KEVIN GREEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELANIE GLOECKLER
DIRECTOR
2128 EL LAGO WAY
JACKSONVILLE FL 32224

Officer/Director/Trustee Two

JEFF HENDERSON
DIRECTOR
7550 COLLINS RD
JACKSONVILLE FL 32244

Officer/Director/Trustee Three

PAUL ZINK
DIRECTOR
7820 JAMES ISLAND TRAIL
JACKSONVILLE FL 32256

Officer/Director/Trustee Four

BRIAN WAGES
DIRECTOR
279 WILLOW GREEN DR
ORANGE PARK FL 32072

Officer/Director/Trustee Five

JUSTIN DE VALERIO
DIRECTOR
12951 THE WOODS DR S
JACKSONVILLE FL 32246

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KELANIE GLOECKLER
Signature Title DIRECTOR
Signature Date 9/28/2020
EIN 82-1876180
Case Number EO-2017271-000287
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACCESS WORSHIP INTERNATIONAL INC
Organization’s Mailing Address PO BOX 51149
City JACKSONVILLE BEACH
State FL
ZIP 32240
Accounting period End 12
Primary contact name KEVIN GREEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELANIE GLOECKLER
DIRECTOR
2358 EAGLES NEST RD
JACKSONVILLE FL 32246

Officer/Director/Trustee Two

CARLOS BOSQUE
DIRECTOR
1020 BAISDEN RD
JACKSONVILLE FL 32218

Officer/Director/Trustee Three

PAUL ZINK
DIRECTOR
7820 JAMES ISLAND TRAIL
JACKSONVILLE FL 32256

Officer/Director/Trustee Four

BRIAN WAGES
DIRECTOR
279 WILLOW GREEN DR
ORANGE PARK FL 32073

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
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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