FORM 1023-EZ for MEMORY MIXER FL INCORPORATED

Field Data
EIN 82-1132050
Case Number EO-2019162-000138
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEMORY MIXER FL INCORPORATED
Organization’s Mailing Address 31790 US HIGHWAY 19N APT 31
City PALM HARBOR
State FL
ZIP 34684
Accounting period End 12
Primary contact name BRANDON HOLLAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRANDON HOLLAND
PRESIDENT
31790 US HIGHWAY 19N APT 31
PALM HARBOR FL 34684

Officer/Director/Trustee Two

BRITANI LALONE
VICE PRESIDENT
31790 US HIGHWAY 19N APT 31
PALM HARBOR FL 34684

Officer/Director/Trustee Three

ERIC WHITED
COO
5206 N FLORIDA AVE
TAMPA FL 33603

Officer/Director/Trustee Four

LAUREN GRAY
CORRESPONDING SECRETARY
775 NORTH VILLIAGE DR N
SAINT PETERSBURG FL 33716

Officer/Director/Trustee Five

SHAVON HOLLAND
OFFICER
4623 HARWICH DR
WALDORF MD 20601

Organization’s website MEMORYMIXERFL.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/6/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BRANDON HOLLAND
Signature Title PRESIDENT
Signature Date 6/9/19

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