FORM 1023-EZ for HOPE CLINIC INC

Field Data
EIN 81-1525260
Case Number EO-2016055-000174
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOPE CLINIC INC
Organization’s Mailing Address 821 NE 36TH TERRACE SUITE 10
City OCALA
State FL
ZIP 34477
Accounting period End 12
Primary contact name CINDY GROW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CINDY GROW
PRESIDENT
15572 SE 138TH TERRACE BOX 431
WEIRSDALE FL 32195

Officer/Director/Trustee Two

MATTHEW GROW
VICE PRESIDENT
15572 SE 138TH TERRACE BOX 431
WEIRSDALE FL 32195

Officer/Director/Trustee Three

ANN EPISCOPO
SECRETARY
5407 SE 108TH ST
BELLEVIEW FL 34420

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/15/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E32 - Ambulatory Health Center, Community Clinic
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 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
Signature Title
Signature Date

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