FORM 1023-EZ for LILLY IN THE VALLEY INC

Field Data
EIN 83-4086378
Case Number EO-2021188-000095
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LILLY IN THE VALLEY INC
Organization’s Mailing Address 1625 W 17TH STREET
City JACKSONVILLE
State FL
ZIP 32209
Accounting period End 12
Primary contact name EUGENE WIGGINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEWARD WASHINGTON II
PRESIDENT
7920 MERRILL ROAD 1001
JACKSONVILLE FL 32277

Officer/Director/Trustee Two

CURTRELL WASHINGTON
VICE PRESIDENT
7920 MERRILL ROAD 1001
JACKSONVILLE FL 32277

Officer/Director/Trustee Three

EUGENE WIGGINS
SECRETARY
6999 MERRILL ROAD STE 2 PMB 227
JACKSONVILLE FL 32277

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/5/2021
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: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name STEWARD WASHINGTON II
Signature Title PRESIDENT
Signature Date 7/5/2021

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