FORM 1023-EZ for SHOOT ME BOOK INC

Field Data
EIN 84-2040024
Case Number EO-2019171-000292
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHOOT ME BOOK INC
Organization’s Mailing Address 2120 SE 171 AVENUE
City SILVER SPRINGS
State FL
ZIP 34488
Accounting period End 12
Primary contact name DIANE LEMON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANE LEMON
PRESIDENT
2120 SE 171 AVENUE
SILVER SPRINGS FL 34488

Officer/Director/Trustee Two

MARJORIE HENDON
TREASURER
11951 NE 52 PLACE ROAD
SILVER SPRINGS FL 34488

Officer/Director/Trustee Three

JOHN POLLACK
SECRETARY
837 QUILLETTE STREET
BEAVERTON MI 48612

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/29/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
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 No
Correctness Declaration Yes
Signature Name DIANE LEMON
Signature Title PRESIDENT
Signature Date 6/18/19

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