FORM 1023-EZ for FLORIDA ADOLESCENT AND YOUNG ADULTSEXUAL HEALTH NETWORK INC

Field Data
EIN 85-1412033
Case Number EO-2020210-000849
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FLORIDA ADOLESCENT AND YOUNG ADULTSEXUAL HEALTH NETWORK INC
Organization’s Mailing Address 7626 SOLIMAR CIR
City BOCA RATON
State FL
ZIP 33433-1035
Accounting period End 12
Primary contact name MICHAEL J BARTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL BARTON
PRESIDENT
7626 SOLIMAR CIR
BOCA RATON FL 33433-1035

Officer/Director/Trustee Two

ANA PUGA
VICE PRESIDENT
1905 N OCEAN BLVD SUITE 4D
FORT LAUDERDALE FL 33305

Officer/Director/Trustee Three

JOSEPH WOLF
TREASURER SECRETARY
3332 SEVILLE ST WEST
JACKSONVILLE FL 32207

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/26/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G81 - AIDS
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 MICHAEL BARTON
Signature Title PRESIDENT
Signature Date 7/26/2020

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