FORM 1023-EZ for FOUR CORNER BUCCANEERS INC

Field Data
EIN 82-0929287
Case Number EO-2017094-000302
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOUR CORNER BUCCANEERS INC
Organization’s Mailing Address 1060 JAYBEE AVE
City DAVENPORT
State FL
ZIP 33897
Accounting period End 12
Primary contact name JEREMIE WOLFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEREMIE WOLFF
PRESIDENT, DIRECTOR
1060 JAYBEE AVE
DAVENPORT FL 33897

Officer/Director/Trustee Two

ANNE BANNING
SECRETARY, DIRECTOR
1060 JAYBEE AVE
DAVENPORT FL 33897

Officer/Director/Trustee Three

AMANDA SIMMONS
TREASURER, DIRECTOR
1060 JAYBEE AVE
DAVENPORT FL 33897

Officer/Director/Trustee Four

CHET WATKINS
DIRECTOR
1060 JAYBEE AVE
DAVENPORT FL 33897

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/17/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 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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