FORM 1023-EZ for VIVA PANAMA USA INC

Field Data
EIN 86-1412214
Case Number EO-2021146-000443
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VIVA PANAMA USA INC
Organization’s Mailing Address 4712 BLOUNT AVENUE
City JACKSONVILLE
State FL
ZIP 32210-8206
Accounting period End 12
Primary contact name RUBY NISSENBAUM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUBY NISSENBAUM
PRESIDENT
4712 BLOUNT AVENUE
JACKSONVILLE FL 32210-8206

Officer/Director/Trustee Two

ANDREA ROSS
VICE PRESIDENT
1259 LIMPKIN LANE
MIDDLEBURG FL 32068-1500

Officer/Director/Trustee Three

JOEL MARTINSON
TREASURER
12027 BRIDGE HAMPTON ROAD
JACKSONVILLE FL 32218-1560

Officer/Director/Trustee Four

JESSICA SERRANO
SECRETARY
3187 STONEBRIER RIDGE DRIVE
ORANGE PARK FL 32065-3199

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/5/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural 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 RUBY NISSENBAUM
Signature Title PRESIDENT
Signature Date 5/24/2021

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