FORM 1023-EZ for DIVINE IMPACT INC
| Field | Data |
|---|---|
| EIN | 36-4854018 |
| Case Number | EO-2017123-000204 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | DIVINE IMPACT INC |
| Organization’s Mailing Address | 5608 KENNY DRIVE |
| City | TAMPA |
| State | FL |
| ZIP | 33617-7711 |
| Accounting period End | 12 |
| Primary contact name | DEBRA WALLACE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DEBRA WALLACE
CEO/PRESIDENT
5608 KENNY DRIVE
TAMPA FL 33617-7711
Officer/Director/Trustee Two
KEITH L KING
DIRECTOR
11311 N 22ND STREET 215
TAMPA FL 33612-6111
Officer/Director/Trustee Three
LAMARIN BROWN
DIRECTOR
1014 E 26TH AVE
TAMPA FL 33605-1752
Officer/Director/Trustee Four
BOBBY FOXWORTH
DIRECTOR
3503 E CARACAS ST
TAMPA FL 33610-6522
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/5/2017 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | S20 - Community, Neighborhood Development, Improvement (General) |
| 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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