FORM 1023-EZ for CASSELBERRY KIDZ INC

Field Data
EIN 47-2383460
Case Number EO-2014328-000332
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CASSELBERRY KIDZ INC
Organization’s Mailing Address 4195 S US HWY 17-92
City CASSELBERRY
State FL
ZIP 32707
Accounting period End 12
Primary contact name JERALD JORDAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES GOODMAN
PRESIDENT
4195 S US HWY 17-92
CASSELBERRY FL 32707

Officer/Director/Trustee Two

JERALD JORDAN
VICE PRESIDENT
4195 S US HWY 17-92
CASSELBERRY FL 32707

Officer/Director/Trustee Three

SANDRA STRANGE
SECRETARY
4195 S US HWY17-92
CASSELBERRY FL 32707

Organization’s website
Organization’s email JGOODMAN@CASSELBERRY.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/27/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 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
Signature Title
Signature Date

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