FORM 1023-EZ for LAKE WALES MUSEUM ASSOCIATION INC

Field Data
EIN 47-4258468
Case Number EO-2018256-000450
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAKE WALES MUSEUM ASSOCIATION INC
Organization’s Mailing Address PO BOX 323
City LAKE WALES
State FL
ZIP 33859
Accounting period End 12
Primary contact name JESSICA BRAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT CONNORS
CHAIRMAN
3311 HARBOR BEACH DRIVE
LAKE WALES FL 33859

Officer/Director/Trustee Two

JESSICA BRAY
PRESIDENT
33 N LAKESHORE BLVD
LAKE WALES FL 33853

Officer/Director/Trustee Three

NANCY GOSSARD
TREASURER
420 EAST BULLARD AVE
LAKE WALES FL 33853

Officer/Director/Trustee Four

JOHN TURLEY
SECRETARY
920 DEVONSHIRE WAY
LAKE WALES FL 33853

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/15
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A50 - Museum, Museum Activities
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JESSICA BRAY
Signature Title PRESIDENT
Signature Date 9/11/18
EIN 47-4258468
Case Number EO-2016148-000109
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKE WALES MUSEUM ASSOCIATION INC
Organization’s Mailing Address PO BOX 323
City LAKE WALES
State FL
ZIP 33859
Accounting period End 12
Primary contact name JESSICA BRAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALEX WHEELER
CHAIRMAN
868 TARTAN LOOP
LAKE WALES FL 33853

Officer/Director/Trustee Two

RICH THOMPSON
PRESIDENT
325 S SCENIC HIGHWAY
LAKE WALES FL 33853

Officer/Director/Trustee Three

ROBERT CONNOR
SECRETARY
3311 HARBOR BEACH DRIVE
LAKE WALES FL 33859

Officer/Director/Trustee Four

JESSICA BRAY
TREASURER
33 N LAKESHORE BLVD
LAKE WALES FL 33853

Officer/Director/Trustee Five

DEMING COWLES
DIRECTOR
31 OAK STREET
BABSON PARK FL 33827

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A50 - Museum, Museum Activities
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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
Signature Title
Signature Date

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