FORM 1023-EZ for ARCADIA CENTENNIAL LIONS CLUB FOUNDATION INC

Field Data
EIN 83-1660955
Case Number EO-2018247-000683
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ARCADIA CENTENNIAL LIONS CLUB FOUNDATION INC
Organization’s Mailing Address 5905 CUBITIS AVE LOT 210
City ARCADIA
State FL
ZIP 34266
Accounting period End 6
Primary contact name CHERYL HALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHERYL HALL
PRESIDENT & REGISTERED AGENT
5905 CUBITIS AVE LOT 210
ARCADIA FL 34266

Officer/Director/Trustee Two

JOHN OLIN
TREASURER
3550 NE HWY 70 LOT 317
ARCADIA FL 34266

Officer/Director/Trustee Three

BUSTER HALL
DIRECTOR
5905 CUBITIS AVE LOT 210
ARCADIA FL 34266

Officer/Director/Trustee Four

NANCY HIGGINBOTHAM
DIRECTOR
7413 COUNTY ROAD 763
ARCADIA FL 34266

Officer/Director/Trustee Five

ALFRED HIGGINBOTHAM
DIRECTOR
7413 COUNTY ROAD 763
ARCADIA FL 34266

Organization’s website N.A.
Organization’s email JHOLIN@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/7/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
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 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 JOHN OLIN
Signature Title TREASURER
Signature Date 8/31/18

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