FORM 1023-EZ for FUNPREDCANCER USA INC

Field Data
EIN 83-1288381
Case Number EO-2018282-000516
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FUNPREDCANCER USA INC
Organization’s Mailing Address 6427 PEMBROKE ROAD
City HOLLYWOOD
State FL
ZIP 33023
Accounting period End 12
Primary contact name DOMINGO JIMENEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FIDEL CASTILLO ROSARIO
DIRECTOR
6427 PEMBROKE ROAD
HOLLYWOOD FL 33023

Officer/Director/Trustee Two

ANA DUARTE
DIRECTOR
6427 PEMBROKE ROAD
HOLLYWOOD FL 33023

Officer/Director/Trustee Three

FERMIN JIMENEZ
DIRECTOR
6427 PEMBROKE ROAD
HOLLYWOOD FL 33023

Officer/Director/Trustee Four

JOSE HERNANDEZ
DIRECTOR
6427 PEMBROKE ROAD
HOLLYWOOD FL 33023

Officer/Director/Trustee Five

DAVID KAPLAN
DIRECTOR
6427 PEMBROKE ROAD
HOLLYWOOD FL 33023

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/5/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 No
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 FIDEL CASTILLO ROSARIO
Signature Title DIRECTOR
Signature Date 10/7/18

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