FORM 1023-EZ for COFFEE TALK VENICE INC

Field Data
EIN 47-2845477
Case Number EO-2015048-000116
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COFFEE TALK VENICE INC
Organization’s Mailing Address 1532 US HWY 41 BYPASS S UNIT 155
City VENICE
State FL
ZIP 34293-1032
Accounting period End 12
Primary contact name CHARLES BLACK PRESIDENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHARLES BLACK
PRESIDENT
1435 E VENICE AVE UNIT 104-153
VENICE FL 34292

Officer/Director/Trustee Two

NEIL WALTENBURG
VICE PRESIDENT
1532 US HWY 41 BY-PASS S UNIT 155
VENICE FL 34293

Officer/Director/Trustee Three

SANDRA BLACK
SECRETARY
1435 E VENICE AVE UNIT 104-153
VENICE FL 34292

Officer/Director/Trustee Four

PATRICIA MOSER
TREASURER
1532 US HWY 41 BY-PASS S UNIT 155
VENICE FL 34293

Officer/Director/Trustee Five

MARY BETH RUNK
OPERATIONS DIRECTOR
1532 US HWY 41 BY-PASS S UNIT 155
VENICE FL 34293

Organization’s website HTTP://WWW.COFFEETALKVENICE.ORG
Organization’s email CONTACT@COFFEETALKVENICE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
Organization’s purpose Charitable: Yes
Religious: Yes
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 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
Signature Title
Signature Date

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