FORM 1023-EZ for BENEVOLENT VINEYARD INC

Field Data
EIN 82-3073771
Case Number EO-2017303-000328
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BENEVOLENT VINEYARD INC
Organization’s Mailing Address 130 COLUMBIA LN NW
City CRESTVIEW
State FL
ZIP 32536
Accounting period End 12
Primary contact name EUGENE HART
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EUGENE HART
PRESIDENT, DIRECTOR
130 COLUMBIA LN NW
CRESTVIEW FL 32536

Officer/Director/Trustee Two

MARSHA MOYE
SECRETARY, DIRECTOR
1145 FARMER ST
CRESTVIEW FL 32539

Officer/Director/Trustee Three

RICHARD HART
TREASURER, DIRECTOR
6235 LAKE ELLA RD
CRESTVIEW FL 32539

Officer/Director/Trustee Four

JEFFREY CRIDER
DIRECTOR
213 ASHLEY DR
CRESTVIEW FL 32536

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/10/2017
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: 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 Yes
Donation of funds Yes
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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