FORM 1023-EZ for JAX KIDZ INC

Field Data
EIN 13-4235919
Case Number EO-2016279-000081
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JAX KIDZ INC
Organization’s Mailing Address 10825 KEY HAVEN BLVD STE 504
City JACKSONVILLE
State FL
ZIP 32218
Accounting period End 12
Primary contact name WANDA MAYES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALLEN SHEFFIELD
CEO
10825 KEY HAVEN BLVD
JACKSONVILLE FL 32218

Officer/Director/Trustee Two

WANDA MAYES
PRESIDENT
11852 LAKE BEND CIRCLE
JACKSONVILLE FL 32218

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/2003
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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