FORM 1023-EZ for EMERALD COAST HEALTH ORGANIZATION

Field Data
EIN 81-1712402
Case Number EO-2016069-000239
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EMERALD COAST HEALTH ORGANIZATION
Organization’s Mailing Address 309 TEQUESTA DR
City DESTIN
State FL
ZIP 32541
Accounting period End 12
Primary contact name DANIEL AUSTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DANIEL AUSTIN
PRESIDENT
309 TEQUESTA DR
DESTIN FL 32541

Officer/Director/Trustee Two

JESSICA AUSTIN
VICE PRESIDENT
309 TEQUESTA DR
DESTIN FL 32541

Officer/Director/Trustee Three

JEREMY AUSTIN
VICE PRESIDENT
1100 SANDAL LANE 1108
PANAMA CITY BEACH FL 32413

Officer/Director/Trustee Four

DOUGLAS MULLING
SECRETARY
288 RAINBOW DR
CRESTVIEW FL 32539

Organization’s website EMERALDCOASTHEALTHORGANIZATION.COM
Organization’s email INFO@EMERALDCOASTHEALTHORGANIZATION.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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
Signature Title
Signature Date

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