FORM 1023-EZ for JACOBS LADDER RANCH INC

Field Data
EIN 84-4129970
Case Number EO-2020058-000376
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JACOBS LADDER RANCH INC
Organization’s Mailing Address 11106 HOTCHKISS DR UNIT A
City SEBASTIAN
State FL
ZIP 32958
Accounting period End 12
Primary contact name JOSEPH CHAPMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH CHAPMAN
PRESIDENT
11106 HOTCHKISS DR UNIT A
SEBASTIAN FL 32958

Officer/Director/Trustee Two

VICK CAMPBELL
TREASURER
2050 DEROSA DR
VERO BEACH FL 32960

Officer/Director/Trustee Three

JOEL BRAY
SECRETARY
6865 33RD AVE
VERO BEACH FL 32967

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/16/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F99 - Mental Health, Crisis Intervention N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 JOSEPH CHAPMAN
Signature Title PRESIDENT
Signature Date 2/25/2020

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