| Field | Data |
|---|---|
| EIN | 86-1720597 |
| Case Number | EO-2021140-000299 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | KETAMINE TASKFORCE INC |
| Organization’s Mailing Address | 22214 HOLLYHOCK TRAIL |
| City | BOCA RATON |
| State | FL |
| ZIP | 33433-4866 |
| Accounting period End | 12 |
| Primary contact name | RENEE STCLAIR |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
KIMBERLY JUROVIESKY
PRESIDENT
22214 HOLLYHOCK TRAIL
BOCA RATON FL 33433-4866
LINDSAY CORLEY
VICE PRESIDENT
1874 SUMTER STREET
ATLANTA GA 30318-2032
ALLISON WELLS
TREASURER
33 PATTI LYNN LANE
HOUSTON TX 77024-7125
| Organization’s website | KETAMINETASKFORCE.COM |
|---|---|
| Organization’s email | KETAMINETASKFORCE@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/2/2021 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F01 - Alliance/Advocacy Organizations |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: Yes Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: No |
| Qualify For Exemption | No |
| Legislation influence | Yes |
| Compensation of Officer director trustee | Yes |
| 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 | 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 | KIMBERLY JUROVIESKY |
| Signature Title | PRESIDENT |
| Signature Date | 5/14/2021 |
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