FORM 1023-EZ for HOUSE OF ANGLES ASSISTED LIVING INC

Field Data
EIN 82-4710633
Case Number EO-2018115-000060
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOUSE OF ANGLES ASSISTED LIVING INC
Organization’s Mailing Address 1220 CADILLAC DRIVE
City DAYTONA BEACH
State FL
ZIP 32117
Accounting period End 12
Primary contact name DEMETRIUS CRANE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAUNDSY WILLIAMS SR
PRESIDENT
1220 CADILLAC DRIVE
DAYTONA BEACH FL 32117

Officer/Director/Trustee Two

JANIE WILLIAMS
VICE PRESIDENT
1220 CADILLAC DRIVE
DAYTONA BEACH FL 32117

Officer/Director/Trustee Three

KIMKESIA MORGAN
SECRETARY
14365 QUEENSIDE STREET
ORLANDO FL 32825

Officer/Director/Trustee Four

SYLVIA STEWARD
DIRECTOR
555 FAITMOUNT ROAD
DAYTONA BEACH FL 32144

Officer/Director/Trustee Five

MICHAEL MORGAN
DIRECTOR
14365 QUEENSIDE STREET
ORLANDO FL 32825

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P75 - Senior Continuing Care Communities
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 LAUNDSY WILLIAMS SR
Signature Title PRESIDENT
Signature Date 4/21/18

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