FORM 1023-EZ for CARIBBEAN ISLAND MINISTRIES

Field Data
EIN 81-2742033
Case Number EO-2016148-000184
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CARIBBEAN ISLAND MINISTRIES
Organization’s Mailing Address 1220 AMBLE LANE
City CLEARWATER
State FL
ZIP 33755
Accounting period End 12
Primary contact name JEFF RUDOLPH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEFFREY RUDOLPH
PRESIDENT
1220 AMBLE LANE
CLEARWATER FL 33755

Officer/Director/Trustee Two

KEVIN SHEPHERD
SECRETARY
5233 PENGUIN DRIVE
HOLIDAY FL 34691

Officer/Director/Trustee Three

KENNETH HOPE
TREASURER
1739 S MARTIN LUTHER KING JR AVE
CLEARWATER FL 33756

Officer/Director/Trustee Four

JIM RUDOLPH
DIRECTOR
1826 MAGNOLIA DRIVE
CLEARWATER FL 33764

Officer/Director/Trustee Five

HERBERTO QUINTERO
DIRECTOR
515 WINDWARD PASSAGE
CLEARWATER FL 33767

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/24/2016
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: No
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 Yes
Donation of funds Yes
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 Yes
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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