FORM 1023-EZ for IVORY CLUB OF TAMPA INC

Field Data
EIN 35-2216100
Case Number EO-2016154-000277
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name IVORY CLUB OF TAMPA INC
Organization’s Mailing Address 6754 WATERTON DRIVE
City RIVERVIEW
State FL
ZIP 33569
Accounting period End 12
Primary contact name SISSE FERGUSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DONALD TEMPLE
DIRECTOR
16404 MILLAN DEAVILLA
TAMPA FL 33613

Officer/Director/Trustee Two

EZEKIEL OSUNTOGUN
VICE PRESIDENT
13942 JACOBSON DRIVE
ODESSA FL 33556

Officer/Director/Trustee Three

MARTIN WILLIAMS
PRESIDENT
6754 WATERTON DRIVE
TAMPA FL 33569

Officer/Director/Trustee Four

JOHNSON AJAO
SECRETARY
15813 PENNINGTON ROAD
TAMPA FL 33624

Officer/Director/Trustee Five

JEAN-PIERRE NZIGA
TREASURER
19305 SANDY SPRINGS CIRCLE
LUTZ FL 33558

Organization’s website WWW.THEIVORYCLUBOFTAMPA.ORG
Organization’s email INFO@THEIVORYCLUBOFTAMPA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2003
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: Yes
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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