FORM 1023-EZ for FLORIDA ASSOCIATION OF CANNABIS THERAPY INC

Field Data
EIN 47-4142219
Case Number EO-2015205-000357
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FLORIDA ASSOCIATION OF CANNABIS THERAPY INC
Organization’s Mailing Address PO BOX 5302
City PLANT CITY
State FL
ZIP 33563
Accounting period End 4
Primary contact name CYNTHIA PETITJEAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES HATCHER
DIR, PRES
3402 MIDWAY ROAD
PLANT CITY FL 33565

Officer/Director/Trustee Two

MINDY HUNT
DIR TRES SEC
3307 JERRY SMITH RD
DOVER FL 33527

Officer/Director/Trustee Three

LISA-MARIE FUSCO
DIR
10926 JOLLYVILLE RD APT 618
AUSTIN TX 78759

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/27/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
Public Safety: No
Amateur Sports: Yes
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 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
Signature Title
Signature Date

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