FORM 1023-EZ for DIAPER BANK FOR NORTHEAST FLORIDA

Field Data
EIN 84-3705200
Case Number EO-2020057-000221
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DIAPER BANK FOR NORTHEAST FLORIDA
Organization’s Mailing Address 10864 STEEDING HORSE DRIVE
City JACKSONVILLE
State FL
ZIP 32257
Accounting period End 12
Primary contact name CRYSTAL PARKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CRYSTAL PARKS
PRESIDENT
10864 STEEDING HORSE DRIVE
JACKSONVILLE FL 32257

Officer/Director/Trustee Two

JAMEYRA ROMAN-ANDRES
TREASURER
10864 STEEDING HORSE DRIVE
JACKSONVILLE FL 32257

Officer/Director/Trustee Three

CONSTANCE ROPER
SECRETARY
10864 STEEDING HORSE DRIVE
JACKSONVILLE FL 32257

Officer/Director/Trustee Four

ANN MCAULIFFE
DIRECTOR
10864 STEEDING HORSE DRIVE
JACKSONVILLE FL 32257

Officer/Director/Trustee Five

JESSICA SALAMEH
DIRECTOR
10864 STEEDING HORSE DRIVE
JACKSONVILLE FL 32257

Organization’s website N/A
Organization’s email INFO@JAXDIAPERBANK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/18/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P60 - Emergency Assistance (Food, Clothing, Cash)
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 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 CRYSTAL PARKS
Signature Title PRESIDENT
Signature Date 2/24/2020

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