FORM 1023-EZ for MIXED USE SPACE INC

Field Data
EIN 47-5181616
Case Number EO-2015287-000106
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MIXED USE SPACE INC
Organization’s Mailing Address 836 NW 12TH ST
City MIAMI
State FL
ZIP 33136
Accounting period End 12
Primary contact name DAVID SALMON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SARAH MICHELLE RUPERT
EXECUTIVE DIRECTOR
1395 BRICKELL AVE SUITE 800
MIAMI FL 33131

Officer/Director/Trustee Two

DAVID H SALMON
DIRECTOR
1395 BRICKELL AVE SUITE 800
MIAMI FL 33131

Officer/Director/Trustee Three

MELINDA HODER
DIRECTOR
1395 BRICKELL AVE SUITE 800
MIAMI FL 33131

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/25/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
Organization’s purpose Charitable: No
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
Signature Title
Signature Date

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