FORM 1023-EZ for GAME PLAN INITIATIVE INC

Field Data
EIN 83-2190450
Case Number EO-2018295-000060
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GAME PLAN INITIATIVE INC
Organization’s Mailing Address 5031 WINDINGBROOK TRL
City WESLEY CHAPEL
State FL
ZIP 33544
Accounting period End 12
Primary contact name DAVICLAR ANDRE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVICLAR ANDRE
PRESIDENT, DIRECTOR
5031 WINDINGBROOK TRL
WESLEY CHAPEL FL 33544

Officer/Director/Trustee Two

JASMINE HAMILTON
SECRETARY, DIRECTOR
1933 BLUE ROCK DR
TAMPA FL 33612

Officer/Director/Trustee Three

ELIZABETH BASTIAN
TREASURER, DIRECTOR
2621 BERMUDA LAKE DR
BRANDON FL 33510

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
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 DAVICLAR ANDRE
Signature Title PRESIDENT, DIRECTOR
Signature Date 10/18/18

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