FORM 1023-EZ for HENRY BROWN ATHLETIC ASSOCIATION INCORPORATED

Field Data
EIN 82-5304751
Case Number EO-2018117-000231
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HENRY BROWN ATHLETIC ASSOCIATION INCORPORATED
Organization’s Mailing Address 221 N HOGAN STREET
City JACKSONVILLE
State FL
ZIP 32202
Accounting period End 5
Primary contact name KASPER R CLAYTON SR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KASPER CLAYTON
PRESIDENT
3603 HAINES STREET
JACKSONVILLE FL 32206

Officer/Director/Trustee Two

TERCELL MCKENZIE
DIRECTOR
1503 EAST 18TH STREET
JACKSONVILLE FL 32206

Officer/Director/Trustee Three

LARRY KIRTSEY
DIRECTOR
1611 EAST 18TH STREET
JACKSONVILLE FL 32206

Officer/Director/Trustee Four

CASSANDRA JOHNSON
DIRECTOR
10770 ANDERS BLVD APT 302
JACKSONVILLE FL 32246

Officer/Director/Trustee Five

JASMINE DINGLE
DIRECTOR
1164 EAST 17TH STREET
JACKSONVILLE FL 32206

Organization’s website
Organization’s email HENRYBROWNAA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 KASPER CLAYTON
Signature Title PRESIDENT
Signature Date 4/25/18

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