FORM 1023-EZ for IMMACULATE CONCEPTION FOUNDATION INC

Field Data
EIN 59-3551363
Case Number EO-2017241-000099
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name IMMACULATE CONCEPTION FOUNDATION INC
Organization’s Mailing Address 5215 TURKEY LAKE RD
City ORLANDO
State FL
ZIP 32819
Accounting period End 12
Primary contact name MERCEDES FERNANDEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MERCEDES FERNANDEZ
PRESIDENT
5215 TURKEY LAKE RD
ORLANDO FL 32819

Officer/Director/Trustee Two

ADALBERTO A HENRIQUEZ
SECRETARY
71 RIVER RIDGE DRIVE
ROCKLEDGE FL 32955

Officer/Director/Trustee Three

ELSA VALDEZ
TREASURER
420 MOORE PARK LANE - 203
MERRITT ISLAND FL 32952

Officer/Director/Trustee Four

MANUEL E FERNANDEZ
DIRECTOR
5215 TURKEY LAKE RD
ORLANDO FL 32819

Officer/Director/Trustee Five

MARGARITA HENRIQUEZ
DIRECTOR
71 RIVER RIDGE DRIVE
ROCKLEDGE FL 32955

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/15/1998
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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