FORM 1023-EZ for COUNTRY CLUB OF MIAMI COMMUNITY ACTION NETWORK INC

Field Data
EIN 83-0949817
Case Number EO-2020031-000305
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COUNTRY CLUB OF MIAMI COMMUNITY ACTION NETWORK INC
Organization’s Mailing Address 6751 SAINT ANDREWS PARKWAY
City HIALEAH
State FL
ZIP 33015-2350
Accounting period End 9
Primary contact name JUDITH SHARPE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT HARRINGTON
PRESIDENT
19500 W ST ANDREWS DRIVE
HIALEAH FL 33015-2342

Officer/Director/Trustee Two

RALPH MILLS
VICE PRESIDENT
6841 N ST ANDREWS DRIVE
HIALEAH FL 33015-2342

Officer/Director/Trustee Three

MARILYN HODGKINS
TREASURER
19426 E LAKE DRIVE
HIALEAH FL 33015-2216

Officer/Director/Trustee Four

JUDITH SHARPE
SECRETARY
19300 E LAKE DRIVE
HIALEAH FL 33015-2214

Officer/Director/Trustee Five

JOHN GOSHGARIAN
DIRECTOR
5550 HAWKES BLUFF AVENUE
DAVIE FL 33331-2500

Organization’s website WWW.CCMCAN.ORG
Organization’s email CONTACT@CCMCAN.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2018
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N6A - Golf
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JUDITH SHARPE
Signature Title SECRETARY
Signature Date 1/29/2020

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