FORM 1023-EZ for ZETA LAKE COUNTY COMMUNITY GROUP INCORPORATED

Field Data
EIN 81-4589997
Case Number EO-2018128-000456
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ZETA LAKE COUNTY COMMUNITY GROUP INCORPORATED
Organization’s Mailing Address 252 WEST ARDICE AVENUE SUITE 415
City EUSTIS
State FL
ZIP 32726
Accounting period End 12
Primary contact name DEBORAH EVANS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBORAH EVANS
CHAIR/PRESIDENT
23718 WOLF BRANCH ROAD
SORRENTO FL 32776

Officer/Director/Trustee Two

DERIETH SUTTON
VICE CHAIR/VICE-PRESIDENT
216 LORI COURT
UMATILLA FL 32784

Officer/Director/Trustee Three

INEZ HALL
SECRETARY
3481 GALESBURG COURT
THE VILLAGES FL 32162

Officer/Director/Trustee Four

MICHELLE PALMER
TREASURE
38125 TIMBERLANE DRIVE
UMATILLA FL 32784

Organization’s website
Organization’s email CHAIRZLCCG@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T70 - Fund Raising Organizations That Cross Categories
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 DEBORAH EVANS
Signature Title CHAIR/PRESIDENT
Signature Date 5/1/18

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