FORM 1023-EZ for MY COMMUNITY CARES INC

Field Data
EIN 46-3723291
Case Number EO-2015078-000303
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MY COMMUNITY CARES INC
Organization’s Mailing Address 1555 NORTH BOULEVARD
City COCOA
State FL
ZIP 32922
Accounting period End 12
Primary contact name CHARLOTTE PERKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JARVIS WASH
PRESIDENT
1555 NORTH COCOA BLVD
COCOA FL 32922

Officer/Director/Trustee Two

CHARLOTTE PERKINS
VP - DIRECTOR
1555 NORTH COCOA BLVD
COCOA FL 32922

Officer/Director/Trustee Three

KENDALL MOORE
DIRECTOR
1555 NORTH COCOA BLVD
COCOA FL 32922

Officer/Director/Trustee Four

LOIS WASH
DIRECTOR
1555 NORTH COCOA BLVD
COCOA FL 32922

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/19/2013
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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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