FORM 1023-EZ for SOUTHERN ICE EXCHANGE INC

Field Data
EIN 47-2865616
Case Number EO-2015026-000139
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTHERN ICE EXCHANGE INC
Organization’s Mailing Address 721 ARGYLE PLACE
City TEMPLE TERRACE
State FL
ZIP 33617
Accounting period End 12
Primary contact name DAWN LADD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GARY BLOODWORTH
PRESIDENT
4116 SOUTH CREEK ROAD
CHATTANOOGA TN 37406

Officer/Director/Trustee Two

SEAN ODOM
VICE PRESIDENT
202 HWY 19 NORTH
MERIDIAN MS 39304

Officer/Director/Trustee Three

DAVID BRYANT
SECRETARY/TREASURER
5849 COMMONWEALTH AVENUE
JACKSONVILLE FL 32254

Officer/Director/Trustee Four

DAWN LADD
EXECUTIVE DIRECTOR
721 ARGYLE PLACE
TEMPLE TERRACE FL 33617

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/16/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S41 - Promotion of Business
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 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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