FORM 1023-EZ for SYNERGY CAMP INC

Field Data
EIN 83-3812146
Case Number EO-2019142-000162
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SYNERGY CAMP INC
Organization’s Mailing Address 5155 FOXHALL DR N
City WEST PALM BEACH
State FL
ZIP 33147
Accounting period End 2
Primary contact name RAY NELSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RAY NELSON
DIRECTOR
5155 FOXHALL DR N
WEST PALM BEACH FL 33147

Officer/Director/Trustee Two

TERRION NELSON
DIRECTOR
5155 FOXHALL DR N
WEST PALM BEACH FL 33147

Officer/Director/Trustee Three

TOVAH LOVELY
DIRECTOR
1842 PALISADES DR
WEST PALM BEACH FL 33411

Organization’s website SYNERGYPERCUSSION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 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 No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RAY NELSON
Signature Title DIRECTOR
Signature Date 5/19/19

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