FORM 1023-EZ for KEILAANDVNCENT MEMORIAL FOUNDATION INC

Field Data
EIN 47-1198728
Case Number EO-2017219-000192
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KEILAANDVNCENT MEMORIAL FOUNDATION INC
Organization’s Mailing Address 812 CARO ST
City CHATTAHOOCHEE
State FL
ZIP 32324
Accounting period End 12
Primary contact name DIANNE DANIELS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANNE DANIELS
PRESIDENT
812 CARO ST
CHATTAHOOCHEE FL 32321

Officer/Director/Trustee Two

TRAYCE DAVIS
VICE PRESIDENT
209 S MALCOLM ST
QUINCY FL 32351

Officer/Director/Trustee Three

LANEKA WILLIAMS
TREASURER
2035 MONDAY ROAD
TALLAHASSEE FL 32301

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 Yes
One Third Support Gifts No
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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