FORM 1023-EZ for SHAWN D DELIFUS FOUNDATION INC

Field Data
EIN 81-3731288
Case Number EO-2016251-000429
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHAWN D DELIFUS FOUNDATION INC
Organization’s Mailing Address 5507 AHMAD DRIVE WEST
City JACKSONVILLE
State FL
ZIP 32209
Accounting period End 6
Primary contact name JOYCE DELIFUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOYCE DELIFUS
PRESIDENT
5507 AHMAD DR WEST
JACKSONVILLE FL 32209

Officer/Director/Trustee Two

DANIEL DELIFUS
VICE PRESIDENT
4274 BROAD CREEK LANE
JACKSONVILLE FL 32218

Officer/Director/Trustee Three

JAMES LEE
TREASURER
5507 AHMAD DR WEST
JACKSONVILLE FL 32209

Officer/Director/Trustee Four

MARY DE JARNETTE
DIRECTOR
1320 BROAD ST NORTH 1012
JACKSONVILLE FL 32202

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/22/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
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 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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