FORM 1023-EZ for SERENITY ISLAND INCORPORATED
| Field | Data |
|---|---|
| EIN | 85-2618597 |
| Case Number | EO-2020268-000415 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SERENITY ISLAND INCORPORATED |
| Organization’s Mailing Address | 2081 PALOMINO DR |
| City | TITUSVILLE |
| State | FL |
| ZIP | 32796 |
| Accounting period End | 12 |
| Primary contact name | SHANA GUDGEL |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SHANA GUDGEL
PRESIDENT TREASURER
2081 PALOMINO DR
TITUSVILLE FL 32796
Officer/Director/Trustee Two
MARK DENNY
CEO
2081 PALOMINO DR
TITUSVILLE FL 32796
Officer/Director/Trustee Three
ERICH BRUEGGEMAN
VICE PRESIDENT
3504 N KENNEY RD
OTIS ORCHARDS WA 99027
Officer/Director/Trustee Four
MELISSA CHRISTENSEN
SECRETARY
24 TROPICAL TRAIL
ORMOND BEACH FL 32176
Officer/Director/Trustee Five
THOMAS CARLIN
CHIEF TECHNICAL OFFICER
6711 HARLAN ST
ARVADA CO 80003
| Organization’s website | SERENITYISLAND.ORG |
|---|---|
| Organization’s email | SERENITYISLANDOFDREAMS@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/23/2020 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G19 - Nonmonetary Support N.E.C. |
| 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 | 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 | SHANA GUDGEL |
| Signature Title | PRESIDENT TREASURER |
| Signature Date | 9/22/2020 |
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