FORM 1023-EZ for INTERCOMMUNITY CANCER FOUNDATION
| Field | Data |
|---|---|
| EIN | 82-3943597 |
| Case Number | EO-2018037-000074 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | INTERCOMMUNITY CANCER FOUNDATION |
| Organization’s Mailing Address | 922 ROLLING ACRES RD STE 1 |
| City | LADY LAKE |
| State | FL |
| ZIP | 32159 |
| Accounting period End | 12 |
| Primary contact name | REBECCA GROHLER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DEBORAH REAGAN
DIRECTOR AND PRESIDENT
922 ROLLING ACRES RD
LADY LAKE FL 32159
Officer/Director/Trustee Two
REBECCA GROHLER
DIRECTOR AND VICE PRESIDERNT
922 ROLLING ACRES RD
LADY LAKE FL 32159
Officer/Director/Trustee Three
EMILY MENDELL
DIRECTOR AND SECRETARY
922 ROLLING ACRES RD
LADY LAKE FL 32159
Officer/Director/Trustee Four
DAVID CATALANO
DIRECTOR
922 ROLLING ACRES RD
LADY LAKE FL 32159
Officer/Director/Trustee Five
BUONOMO MICHAEL
DIRECTOR
17312 SE 85TH WILLOWWICK CIR
THE VILLAGES FL 32162
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/1/18 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | T30 - Public Foundations |
| 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 | 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 | 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 | REBECCA GROHLER |
| Signature Title | DIRECTOR AND VICE PRESIDERNT |
| Signature Date | 2/2/18 |
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