FORM 1023-EZ for LIVE FRESH INC

Field Data
EIN 81-3772187
Case Number EO-2016344-000390
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIVE FRESH INC
Organization’s Mailing Address 3040 LAKE SHORE DRIVE APT 605
City RIVIERA BEACH
State FL
ZIP 33404
Accounting period End 12
Primary contact name WILLIE C BENTLEY JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIE C BENTLEY JR
PRESIDENT
3040 LAKE SHORE DRIVE APT 605
RIVIERA BEACH FL 33404

Officer/Director/Trustee Two

RICHARD CAMPILLO
VICE - PRESIDENT
1201 SOUTH OCEAN DRIVE APT 1411
HOLLYWOOD FL 33019

Officer/Director/Trustee Three

PARIS CALHOUN
SECRETARY - TREASURER
208 HAWTHORNE DRIVE
LAKE PARK FL 33403

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/2/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
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 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
Signature Title
Signature Date

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