FORM 1023-EZ for AMAZING GRACE AIDS MINISTRY INC

Field Data
EIN 81-4692440
Case Number EO-2016357-000160
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMAZING GRACE AIDS MINISTRY INC
Organization’s Mailing Address 6119 55TH TER E
City BRADENTON
State FL
ZIP 34203
Accounting period End 12
Primary contact name BRYAN OCARROLL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRYAN OCARROLL
PRESIDENT, DIRECTOR
6119 55TH TER E
BRADENTON FL 34203

Officer/Director/Trustee Two

JASON COLLINS
SECRETARY, DIRECTOR
710 MAIN ST
CONWAY SC 29526

Officer/Director/Trustee Three

WILLIAM EDWARDS
TREASURER, DIRECTOR
PO BOX 5068
SOUTHAMPTON NY 11969

Officer/Director/Trustee Four

ARLEEN CLARK-FELLENZ
DIRECTOR
W153 N5187 PLAZA DR
MENOMONEE FALLS WI 53051

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/2016
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: Yes
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 No
Donation of funds Yes
Conducting Activities Outside of United States Yes
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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