FORM 1023-EZ for ORTHODOX MENS CLUB

Field Data
EIN 20-0695237
Case Number EO-2015127-000390
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ORTHODOX MENS CLUB
Organization’s Mailing Address 409 S OLD COACHMAN RD
City CLEARWATER
State FL
ZIP 33765
Accounting period End 12
Primary contact name PETER POULOS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PETER POULOS
PRESIDENT
409 S OLD COACHMAN RD
CLEARWATER FL 33765

Officer/Director/Trustee Two

STEVEN CHICKOS
VICE-PRESIDENT
1005 MAIN ST
SAFETY HARBOR FL 34695

Officer/Director/Trustee Three

SAM BUCLOUS
TREASURER
255 DOLPHIN POINT 203
CLEARWATER FL 33767

Officer/Director/Trustee Four

ANDREAS BOUSDOUKOS
SECRETARY
409 S OLD COACHMAN RD
CLEARWATER FL 33761

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/10/2011
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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