FORM 1023-EZ for CORNELIUS COMMUNITY CARE INC

Field Data
EIN 85-1409470
Case Number EO-2021207-000335
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CORNELIUS COMMUNITY CARE INC
Organization’s Mailing Address 3325 HOLLYWOOD BOULEVARD SUITE 403
City HOLLYWOOD
State FL
ZIP 33021-6926
Accounting period End 12
Primary contact name AUDREYA MCLEAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AUDREYA MCLEAN
PRESIDENT
5300 ALTON ROAD
MIAMI BEACH FL 33140-2015

Officer/Director/Trustee Two

JOSEPH NABAKA
SECRETARY
5300 ALTON ROAD
MIAMI BEACH FL 33140-2015

Officer/Director/Trustee Three

DIANA CAICEDO
TREASURER
5300 ALTON ROAD
MIAMI BEACH FL 33140-2015

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/10/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P01 - Alliance/Advocacy Organizations
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name AUDREYA MCLEAN
Signature Title PRESIDENT
Signature Date 7/23/2021

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