FORM 1023-EZ for OPA-LOCKA BOOSTER CLUB AND COMMUNITY SERVICE PROGRAM

Field Data
EIN 85-3078281
Case Number EO-2020282-000099
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OPA-LOCKA BOOSTER CLUB AND COMMUNITY SERVICE PROGRAM
Organization’s Mailing Address 770 OPA LOCKA BLVD
City OPA LOCKA
State FL
ZIP 33054
Accounting period End 12
Primary contact name NATASHA ERVIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATASHA ERVIN
PRESIDENT
670 DUNAD AVENUE
OPA LOCKA FL 33054

Officer/Director/Trustee Two

ANGELINA ROBERTS
1ST VICE PRESIDENT
540 SHARAR AVE
NORTH MIAMI, FL 33167

Officer/Director/Trustee Three

ALVIN BURKE
2ND VICE PRESIDENT
1240 JANN AVENUE
OPA LOCKA FL 33054

Officer/Director/Trustee Four

JONTIKQUA ROBERTS
TREASURE
2260 SERVICE ROAD
NORTH MIAMI, FL 33167

Officer/Director/Trustee Five

ZONYA RAY
SECRETARY
1820 RUTLAND ST
OPA LOCKA FL 33054

Organization’s website
Organization’s email NATASHAERVIN68@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/18/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O23 - Boys and Girls Clubs (Combined)
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 Yes
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 NATASHA ERVIN
Signature Title PRESIDENT
Signature Date 10/6/2020

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