FORM 1023-EZ for H L DERICHO FOUNDATION INC

Field Data
EIN 81-5306470
Case Number EO-2020244-000578
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name H L DERICHO FOUNDATION INC
Organization’s Mailing Address 927 SOUTH CENTRAL AVE
City APOPKA
State FL
ZIP 32712
Accounting period End 12
Primary contact name KENYA MUNOZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KENYA MUNOZ
PRESIDENT
927 SOUTH CENTRAL AVE
APOPKA FL 32712

Officer/Director/Trustee Two

TERRANCE DERICHO
VICE PRESIDENT
927 SOUTH CENTRAL AVE
APOPKA FL 32712

Officer/Director/Trustee Three

MARILYN PERKINS
TREASURER
927 SOUTH CENTRAL AVE
APOPKA FL 32712

Officer/Director/Trustee Four

ALICE ROZIER
SECRETARY
927 SOUTH CENTRAL AVE
APOPKA FL 32712

Officer/Director/Trustee Five

OTHELLO SWIFT
MANAGER
927 SOUTH CENTRAL AVE
APOPKA FL 32712

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/2017
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: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KENYA MUNOZ
Signature Title PRESIDENT
Signature Date 8/28/2020
EIN 81-5306470
Case Number EO-2019030-000933
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name H L DERICHO FOUNDATION INC
Organization’s Mailing Address 927 SOUTH CENTRAL AVE
City APOPKA
State FL
ZIP 32712
Accounting period End 12
Primary contact name KENYA MUNOZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KENYA MUNOZ
PRESIDENT
927 SOUTH CENTRAL AVE
APOPKA FL 32712

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/17
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: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
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 KENYA MUNOZ
Signature Title PRESIDENT
Signature Date 12/28/18

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