FORM 1023-EZ for ACCESS TO LIFE ADVOCACY SERVICES INC

Field Data
EIN 47-2595619
Case Number EO-2016155-000174
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACCESS TO LIFE ADVOCACY SERVICES INC
Organization’s Mailing Address 5542 ORTEGA PARK BLVD
City JACKSONVILLE
State FL
ZIP 32244
Accounting period End 12
Primary contact name YARA BANKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

YARA BANKS
PRESIDENT
5542 ORTEGA PARK BLVD
JACKSONVILLE FL 32244

Officer/Director/Trustee Two

ADRIANE MCDONALD
VICE PRESIDENT
2150 SPENCE RD
ORANGE PARK FL 32073

Officer/Director/Trustee Three

NATASHA SLAUGHTER
OFFICER
4483 CAMPUS HILL CIR
JACKSONVILLE FL 32218

Officer/Director/Trustee Four

KEVIN TAYLOR
OFFICER
450 FOREST MEADOW LANE
ORANGE PARK FL 32065

Officer/Director/Trustee Five

FLORA COLEMAN
SECRETARY/ TREASU
11217 FORESTDALE RD
JACKSONVILLE FL 32218

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/19/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G44 - Kidney Disease
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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