FORM 1023-EZ for NLS ACADEMY INC

Field Data
EIN 81-4080082
Case Number EO-2017079-000059
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NLS ACADEMY INC
Organization’s Mailing Address 11521 TAFT STREET
City PEMBROKE PINES
State FL
ZIP 33026
Accounting period End 12
Primary contact name JACALYN A ROBINSON CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

OCTAVIANO ZAMUDIO
PRESIDENT
11521 TAFT STREET
PEMBROKE PINES FL 33026

Officer/Director/Trustee Two

FLAVIAN HUNTER
TREASURER
11521 TAFT STREET
PEMBROKE PINES FL 33026

Officer/Director/Trustee Three

LAUTARO SALEME
DIRECTOR
11521 TAFT STREET
PEMBROKE PINES FL 33026

Officer/Director/Trustee Four

LEANDRO IBANEZ
DIRECTOR
11521 TAFT STREET
PEMBROKE PINES FL 33026

Officer/Director/Trustee Five

ALONZO GUTIERREZ
DIRECTOR
11521 TAFT STREET
PEMBROKE PINES FL 33026

Organization’s website WWW.NLSOCCERACADEMY.COM
Organization’s email NLSOCCERACADEMY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N40 - Sports Training Facilities, Agencies
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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
Signature Title
Signature Date

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