FORM 1023-EZ for CHAPTER 1 FOUNDATION INC

Field Data
EIN 82-1226633
Case Number EO-2017131-000249
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHAPTER 1 FOUNDATION INC
Organization’s Mailing Address 2190 RESERVE PARK TRACE NUMBER 13
City PORT SAINT LUCIE
State FL
ZIP 34986
Accounting period End 12
Primary contact name TRAVIS MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRAVIS MARTIN
PRESIDENT
47 SE BEECH TREE LANE
STUART FL 34994

Officer/Director/Trustee Two

BARBARA JURGENS
VICE PRESIDENT
319 BAYFRONT TERRACE
SEBASTIAN FL 32958

Officer/Director/Trustee Three

EMILY MACCONNELL
DIRECTOR
12625 83RD STREET
FELLSMERE FL 32948

Officer/Director/Trustee Four

DAVID REEVES
DIRECTOR
4803 SEAGRAPE DR
FORT PIERCE FL 34982

Organization’s website
Organization’s email CHAPTER1FOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/19/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 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
Signature Title
Signature Date

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