FORM 1023-EZ for INITIATIVE COMMUNITY INTERNATIONAL INC

Field Data
EIN 82-0827123
Case Number EO-2017079-000417
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INITIATIVE COMMUNITY INTERNATIONAL INC
Organization’s Mailing Address 4760 NW 24TH CT APT 106B
City LAUDERDALE LAKES
State FL
ZIP 33313
Accounting period End 12
Primary contact name GUBERT SAINT-FLEURY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GUBERT SAINT-FLEURY
PRESIDENT, DIRECTOR
4760 NW 24TH CT APT 106B
LAUDERDALE LAKES FL 33313

Officer/Director/Trustee Two

NEHEMIE LOISEAU
SECRETARY, DIRECTOR
4760 NW 24TH CT APT 106B
LAUDERDALE LAKES FL 33313

Officer/Director/Trustee Three

AUGULUS ST-FLEURY
TREASURER, DIRECTOR
4760 NW 24TH CT APT 106B
LAUDERDALE LAKES FL 33313

Officer/Director/Trustee Four

THOMAS RICARDO
DIRECTOR
4760 NW 24TH CT APT 106B
LAUDERDALE LAKES FL 33313

Officer/Director/Trustee Five

ROODY DURANAY
DIRECTOR
4760 NW 24TH CT APT 106B
LAUDERDALE LAKES FL 33313

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/2017
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: 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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
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
Signature Title
Signature Date

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