FORM 1023-EZ for BRAIN ANEURYSM AND AVM AWARENESS THE CHELSEA KING BURNEY CHARITY INC

Field Data
EIN 85-1444690
Case Number EO-2021083-000224
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BRAIN ANEURYSM AND AVM AWARENESS THE CHELSEA KING BURNEY CHARITY INC
Organization’s Mailing Address PO BOX 215
City WEBSTER
State FL
ZIP 33597
Accounting period End 12
Primary contact name JEAN KING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEAN KING
PRESIDENT
8098 CR 747
WEBSTER FL 33597

Officer/Director/Trustee Two

MICHELLE KING
VICE PRESIDENT
316 WOODLIEF FARM RD
ROLSEVILLE NC 27571

Officer/Director/Trustee Three

HOLLY WILLIAMS
SECRETARY
8745 SPYGLASS LOOP
CLERMONT FL 34711

Officer/Director/Trustee Four

LISA JENSON
TREASURER
8800 SPYGLASS LOOP
CLERMONT FL 34711

Officer/Director/Trustee Five

CAROLYNE PARISH
MEMBER AT LARGE
801 OAK DRIVE
GROVELAND FL 34736

Organization’s website WWW,CKBCHARITY.ORG
Organization’s email CHELSEAKINGBURNEYCHARITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 Yes
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 JEAN KING
Signature Title PRESIDENT
Signature Date 10/9/2020

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