FORM 1023-EZ for GENESIS ICE INC

Field Data
EIN 82-4703911
Case Number EO-2018071-000168
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GENESIS ICE INC
Organization’s Mailing Address 8233 BAYWOOD VISTA DRIVE
City ORLANDO
State FL
ZIP 32810
Accounting period End 12
Primary contact name KEITH LAPRADE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEITH LAPRADE
PRESIDENT
8233 BAYWOOD VISTA DRIVE
ORLANDO FL 32810

Officer/Director/Trustee Two

TAMMY CHRISTIANSEN
TREASURER
8233 BAYWOOD VISTA DRIVE
ORLANDO FL 32810

Officer/Director/Trustee Three

PAMELA BELL
SECRETARY
8233 BAYWOOD VISTA DRIVE
ORLANDO FL 32810

Organization’s website
Organization’s email KEITHLAPRADE@USA.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/10/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KEITH LAPRADE
Signature Title PRESIDENT
Signature Date 3/8/18

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