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CROCKETT FOUNDATION INC. - Florida Company Profile

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Company Details

Entity Name: CROCKETT FOUNDATION INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 15 Apr 2005 (20 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 20 Jan 2015 (10 years ago)
Document Number: N05000003896
FEI/EIN Number 202689974

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 5101 NW 21ST AVE, Fort Lauderdale, FL, 33309, US
Mail Address: 5101 NW 21ST AVE, Fort Lauderdale, FL, 33309, US
ZIP code: 33309
County: Broward
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
CROCKETT ZACHARY Director 3129 NW 82ND TERRACE, COOPER CITY, FL, 33024
Munoz Eric Treasurer 3129 NW 82nd Terr, Cooper City, FL, 33024
CROCKETT ZACHARY Vice President 3129 NW 82ND TERRACE, COOPER CITY, FL, 33024
Biard Benjamin Director 3129 NW 82nd Terr, Cooper City, FL, 33024
CROCKETT HENRI President 3129 NW 82ND TERRACE, COOPER CITY, FL, 33024
CROCKETT HENRI Director 3129 NW 82ND TERRACE, COOPER CITY, FL, 33024
Henri Crockett Agent 5101 NW 21st ave, Fort Lauderdale, FL, 33309
STOCKER MICHELE Director 3000 NE 188TH ST UNIT 605, AVENTURA, FL, 33180
Spoto Marc Director 400 SW 1st Ave, Fort Lauderdale, FL, 33301

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
QJJBS3KBFDK5
CAGE Code:
6GXG8
UEI Expiration Date:
2025-02-28

Business Information

Activation Date:
2024-03-04
Initial Registration Date:
2011-08-03

Commercial and government entity program

The The Commercial And Government Entity Code (CAGE) is assigned by the Department of Defense's Defense Logistics Agency (DLA) and represents your company's physical address for GSA's mailings, payments, and administrative records.

Note: A CAGE Code enables a company to contract with the U.S. government, allowing bid on government contracts and to receive government payments. Also for business this means that it's a Verified business entity and Has a validated physical address.

CAGE number:
6GXG8
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2025-02-28
SAM Expiration:
2025-02-28

Contact Information

POC:
HENRI CROCKETT
Corporate URL:
http://www.crockettfoundation.org

National Provider Identifier

NPI Number:
1184295123
Certification Date:
2021-07-09

Authorized Person:

Name:
MS. REGINE KANZKI
Role:
VICE PRESIDENT OF OPERATIONS
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2022-01-24 5101 NW 21st ave, 530, Fort Lauderdale, FL 33309 -
CHANGE OF PRINCIPAL ADDRESS 2020-01-15 5101 NW 21ST AVE, STE 530, Fort Lauderdale, FL 33309 -
CHANGE OF MAILING ADDRESS 2020-01-15 5101 NW 21ST AVE, STE 530, Fort Lauderdale, FL 33309 -
REINSTATEMENT 2015-01-20 - -
REGISTERED AGENT NAME CHANGED 2015-01-20 Henri Crockett -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2014-09-26 - -
REINSTATEMENT 2013-03-22 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2012-09-28 - -

Documents

Name Date
ANNUAL REPORT 2024-02-06
ANNUAL REPORT 2023-04-18
ANNUAL REPORT 2022-01-24
AMENDED ANNUAL REPORT 2021-06-01
ANNUAL REPORT 2021-01-14
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-02-08
ANNUAL REPORT 2018-01-22
ANNUAL REPORT 2017-05-02
ANNUAL REPORT 2016-04-14

USAspending Awards / Financial Assistance

Date:
2021-02-06
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
121675.02
Total Face Value Of Loan:
121675.02
Date:
2021-01-07
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
150000.00
Total Face Value Of Loan:
500000.00
Date:
2020-07-09
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-28
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
117487.45
Total Face Value Of Loan:
117487.45

Tax Exempt

Employer Identification Number (EIN) :
47-4242216
In Care Of Name:
% DEBORAH MROZINSKI
Classification:
Educational Organization, Local Association of Employees, Horticultural Organization, Business League, Voluntary Employees' Beneficiary Association (Govt. Emps.), Mutual Ditch or Irrigation Co., Cemetery Company, Other Mutual Corp. or Assoc.
Ruling Date:
2015-09
National Taxonomy Of Exempt Entities:
Mental Health & Crisis Intervention: Mental Health Treatment F31 Psychiatric, Mental Health Hospital
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters

Employer Identification Number (EIN) :
20-2689974
In Care Of Name:
% HENRI CROCKETT
Classification:
Educational Organization, Local Association of Employees, Horticultural Organization, Business League, Voluntary Employees' Beneficiary Association (Govt. Emps.), Mutual Ditch or Irrigation Co., Cemetery Company, Other Mutual Corp. or Assoc.
Ruling Date:
2014-03
National Taxonomy Of Exempt Entities:
Philanthropy, Voluntarism and Grantmaking Foundations: Private Grantmaking Foundations
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Paycheck Protection Program

Date Approved:
2021-02-06
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
121675.02
Current Approval Amount:
121675.02
Race:
Black or African American
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
123300.73
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
117487.45
Current Approval Amount:
117487.45
Race:
Black or African American
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
119488

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Date of last update: 02 Jun 2025

Sources: Florida Department of State