FORM 1023-EZ for NORTH FLORIDA BIRTH ALLIANCE

Field Data
EIN 84-3701789
Case Number EO-2019322-000523
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTH FLORIDA BIRTH ALLIANCE
Organization’s Mailing Address 1988 ASHTON STREET
City MIDDLEBURG
State FL
ZIP 32068
Accounting period End 12
Primary contact name JENN STONE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER STONE
PRESIDENT
1988 ASHTON STREET
MIDDLEBURG FL 32068

Officer/Director/Trustee Two

DREW MAIDER
MANAGER
1875 HARBOR ISLAND DRIVE
FLEMING ISLAND FL 32003

Officer/Director/Trustee Three

JESSICA WILLIS
VICE PRESIDENT
10852 WINGATE RD
JACKSONVILLE FL 32218

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/15/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 JENNIFER STONE
Signature Title PRESIDENT
Signature Date 11/15/19

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