FORM 1023-EZ for THE IMPACT ZONE RECREATION CENTER

Field Data
EIN 46-2301030
Case Number EO-2014251-000460
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE IMPACT ZONE RECREATION CENTER
Organization’s Mailing Address 2739 FAITH CIRCLE
City PALM HARBOR
State FL
ZIP 34684-3942
Accounting period End 12
Primary contact name BLAIR WALLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOELLEN WALLER
PRESIDENT
2739 FAITH CIR
PALM HARBOR FL 34684-3942

Officer/Director/Trustee Two

BLAIR WALLER
SECRETARY
2739 FAITH CIR
PALM HARBOR FL 34684-3942

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/18/2013
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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
Signature Title
Signature Date

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