FORM 1023-EZ for SRNA USF INC

Field Data
EIN 82-4996542
Case Number EO-2020237-000170
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SRNA USF INC
Organization’s Mailing Address 7901 4TH ST N STE 300
City ST PETERSBURG
State FL
ZIP 33702
Accounting period End 12
Primary contact name BRITTANY REESER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUMMER STANFIELD
PRESIDENT, DIRECTOR
4003 S WESTSHORE AVE APT 4505
TAMPA FL 33611

Officer/Director/Trustee Two

JACQUELINE MULDER
TREASURER, DIRECTOR
116 W CHELSEA ST
TAMPA FL 33603

Officer/Director/Trustee Three

MORGAN PECKNOLD
OPERATIONAL OFFICER, DIRECTOR
4003 S WESTSHORE BLVD APT 3006
TAMPA FL 33611

Officer/Director/Trustee Four

BRITTANY REESER
VICE PRESIDENT, DIRECTOR
9864 BOSQUE CREEK CIR APT 304
TAMPA FL 33619

Organization’s website WWW.USF.CAMPUSLABS.COM/ENGAGE/ORGANIZATION/STUDENT-REGISTERED-NURSE-ANESTHETISTS-AT-USF
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/26/2018
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 No
Donation of funds No
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 BRITTANY REESER
Signature Title VICE PRESIDENT, DIRECTOR
Signature Date 8/20/2020

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