FORM 1023-EZ for PROTECT U S WORKERS INC

Field Data
EIN 81-2479252
Case Number EO-2016134-000105
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PROTECT U S WORKERS INC
Organization’s Mailing Address 2243 PALM TER
City SARASOTA
State FL
ZIP 34231
Accounting period End 12
Primary contact name SARA BLACKWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SARA BLACKWELL
PRESIDENT, DIRECTOR
2243 PALM TER
SARASOTA FL 34231

Officer/Director/Trustee Two

YOUNIS ZUBCHEVICH
SECRETARY, DIRECTOR
3301 N EAST 1ST AVE STE 1810
MIAMI FL 33137

Officer/Director/Trustee Three

JOELINE WELLS
TREASURER, DIRECTOR
5610 SAINT LOUIS AVE
SARASOTA FL 34233

Organization’s website WWW.PROTECTUSWORKERS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/25/2016
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: 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 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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