FORM 1023-EZ for THE REVIVE FOUNDATION INC

Field Data
EIN 84-3935434
Case Number EO-2020010-000378
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE REVIVE FOUNDATION INC
Organization’s Mailing Address 53 NW 106 ST
City MIAMI
State FL
ZIP 33150
Accounting period End 12
Primary contact name SUNJA LEON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANA BURKE-LEON
PRESIDENT
780 NE 69 ST APT 1005
MIAMI FL 33138

Officer/Director/Trustee Two

KATIA PHILIPPEAUX
VICE PRESIDENT
12500 SW 5TH COURT M110
MIAMI FL 33027

Officer/Director/Trustee Three

MICHELLE BENJAMIN
SECRETARY
1316 EAST 35 STREET
BALTIMORE MD 21218

Officer/Director/Trustee Four

SUNJA LEON
TREASURER
53 NW 106ST
MIAMI FL 33150

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 No
Donation of funds No
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 SUNJA LEON
Signature Title TREASURER
Signature Date 1/8/2020

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