FORM 1023-EZ for JAY HIGH SCHOOL CLASS OF 2020

Field Data
EIN 84-2019259
Case Number EO-2020108-000210
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JAY HIGH SCHOOL CLASS OF 2020
Organization’s Mailing Address 1028 CHUMUCKLA SPRINGS RD
City JAY
State FL
ZIP 32565
Accounting period End 12
Primary contact name JULIE STAROSTA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATELYN STAROSTA
PRESIDENT
10288 CHUMUCKLA SPRINGS RD
JAY FL 32565

Officer/Director/Trustee Two

BRYNN BURGESS
VICE PRESIDENT
3741 SCHOOL STREET
JAY FL 32565

Officer/Director/Trustee Three

JUDD SMITH
SECRETARY
3741 SCHOOL STREET
JAY FL 32565

Officer/Director/Trustee Four

ALLIE ODOM
TREASURER
3741 SCHOOL STREET
JAY FL 32565

Officer/Director/Trustee Five

JULIE STAROSTA
PARENT SUPERVISOR
10288 CHUMUCKLA SPRINGS RD
JAY FL 32565

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/6/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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 JULIE STAROSTA
Signature Title PARENT SUPERVISOR
Signature Date 4/15/2020

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