FORM 1023-EZ for JACCIS INCORPORATED

Field Data
EIN 86-1569515
Case Number EO-2021078-001057
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JACCIS INCORPORATED
Organization’s Mailing Address 5710 N MIAMI AVE
City MIAMI
State FL
ZIP 33127-1624
Accounting period End 12
Primary contact name ARY JACCIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ARY JACCIS
DIRECTOR/PRESIDENT
5710 NORTH MIAMI AVE
MIAMI FL 33127-1624

Officer/Director/Trustee Two

EMMANESSEAU LAMARRE
DIRECTOR/VICE PRESIDENT
4508 JACKSON STREET
HOLLYWOOD FL 33021-7222

Officer/Director/Trustee Three

DJFERSON JACCIS
DIRECTOR/SECRETARY
70 NW 51ST STREET
MIAMI FL 33127-2114

Officer/Director/Trustee Four

BACHELER JEAN PIERRE
DIRECTOR
503 NW 47TH STREET
MIAM FL 33127-2452

Officer/Director/Trustee Five

WILBERT LUBIN
DIRECTOR/TREASURER
6911 NW 6TH AVE
MIAMI FL 33150-3801

Organization’s website N/A
Organization’s email AJACCIS10@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/15/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O51 - Youth Community Service Clubs
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 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 ARY JACCIS
Signature Title DIRECTOR/PRESIDENT
Signature Date 1/23/2021

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