FORM 1023-EZ for JACKSONVILLE AUTISTIC SOCIETY INC

Field Data
EIN 83-3881291
Case Number EO-2021034-000222
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JACKSONVILLE AUTISTIC SOCIETY INC
Organization’s Mailing Address 4116 LORI DRIVE WEST
City JACKSONVILLE
State FL
ZIP 32207
Accounting period End 12
Primary contact name DEMETRIA WALKER PRESIDENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEMETRIA WALKER
PRESIDENT
4116 LORI DRIVE WEST
JACKSONVILLE FL 32207

Officer/Director/Trustee Two

CHRISTOPHER SPENCER SR
VICE PRESIDENT
4116 LORI DRIVE WEST
JACKSONVILLE FL 32207

Officer/Director/Trustee Three

TAWANA SMITH
SECRETARY
2818 COACHMAN LAKES CURT
JACKSONVILLE FL 32224

Officer/Director/Trustee Four

KHEBE BROWN
TREASURER
2020 CONTINENTAL AVE APT 104
TALLAHASSEE FL 32304

Officer/Director/Trustee Five

KIMBRETTA CLAY
BOARD OF DIRECTOR
6650 CORPORATE CENTER PKWY UNIT 604
JACKSONVILLE FL 32216

Organization’s website HTTPS://JAXAUTISTICSOCIETY.COM/
Organization’s email JAXASOCIETY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/4/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
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 DEMETRIA WALKER
Signature Title PRESIDENT
Signature Date 12/8/2020

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