FORM 1023-EZ for ELITE SKILLS DEVELOPMENT ACADEMY

Field Data
EIN 82-3119327
Case Number EO-2018100-000079
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ELITE SKILLS DEVELOPMENT ACADEMY
Organization’s Mailing Address 4517 CROSSTIE RD N
City JACKSONVILLE
State FL
ZIP 32257-8196
Accounting period End 12
Primary contact name RICHARD GROOMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD GROOMS
DIRECTOR OF SPORTS OPERATIONS
4517 CROSSTIE RD N
JACKSONVILLE FL 32257

Officer/Director/Trustee Two

ARTIZELL GROOMS
FINANCE DIRECTOR
4517 CROSSTIE RD N
JACKSONVILLE FL 32257-8196

Officer/Director/Trustee Three

KYRONDA THOMAS
DIRECTOR OF ADMINISTRATION
4733 IRVINGTON AVE
JACKSONVILLE FL 32210

Officer/Director/Trustee Four

FRANITA ADAMS
DIRECTOR OF FUNDRASING
3750 SILVER BLUFF BLVD 2807
ORANGE PARK FL 32065

Officer/Director/Trustee Five

INDIA CANNON
COACH
10937 HIDDEN HAVEN COURT
JACKSONVILLE FL 32218

Organization’s website HTTP://ELITESKILLSACADEMY.VPWEB.COM/
Organization’s email ELITESDACADEMY@OUTLOOK.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/18/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RICHARD GROOMS
Signature Title DIRECTOR OF SPORTS OPERATIONS
Signature Date 4/5/18

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