FORM 1023-EZ for FOUNDATION FOR CHRONIC CARE ASSISTANCE INC

Field Data
EIN 84-4274754
Case Number EO-2020023-000268
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOUNDATION FOR CHRONIC CARE ASSISTANCE INC
Organization’s Mailing Address 10017 LAKE DISTRICT LANE
City ORLANDO
State FL
ZIP 32832
Accounting period End 12
Primary contact name MARK COLANGELO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK COLANGELO
DIRECTOR/PRESIDENT/SECRETARY
10017 LAKE DISTRICT LANE
ORLANDO FL 32832

Officer/Director/Trustee Two

KEITH SHELLY
DIRECTOR/VP/TREASURER
2427 HYATT CREEK LANE
PORT ORANGE FL 32128

Officer/Director/Trustee Three

ANELA CIZMIC
DIRECTOR
7341 W SAND LAKE RD UNIT 1017
ORLANDO FL 32819

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/20/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G99 - Diseases, Disorders, Medical Disciplines N.E.C.
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 No
Donation of funds Yes
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 No
Correctness Declaration Yes
Signature Name MARK COLANGELO
Signature Title DIRECTOR/PRESIDENT/SECRETARY
Signature Date 1/20/2020

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