FORM 1023-EZ for CREW COMMUNITY HEALTH INC

Field Data
EIN 84-4928742
Case Number EO-2020064-000332
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CREW COMMUNITY HEALTH INC
Organization’s Mailing Address 8601 COMMODITY CIRCLE
City ORLANDO
State FL
ZIP 32819
Accounting period End 12
Primary contact name ERICK SUAREZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERICK SUAREZ
P
8601 COMMODITY CIRCLE
ORLANDO FL 32819

Officer/Director/Trustee Two

CHAD STOWERS
VP
8601 COMMODITY CIRCLE
ORLANDO FL 32819

Officer/Director/Trustee Three

KATRINA GARCIA
SEC
8601 COMMODITY CIRCLE
ORLANDO FL 32819

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E32 - Ambulatory Health Center, Community Clinic
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KATRINA GARCIA
Signature Title SEC
Signature Date 3/2/2020

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