FORM 1023-EZ for MEMORY LOSS LEGAL SERVICES INC

Field Data
EIN 87-1873971
Case Number EO-2021210-000351
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEMORY LOSS LEGAL SERVICES INC
Organization’s Mailing Address 761 NE 73RD STREET
City MIAMI
State FL
ZIP 33138
Accounting period End 12
Primary contact name HEATHER B CARNEVALE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HEATHER CARNEVALE
CHAIR
761 NE 73RD STREET
MIAMI FL 33138

Officer/Director/Trustee Two

JENNIFER SQUILLA
VICE-CHAIR
135 NE 98TH STREET
MIAMI SHORES FL 33138

Officer/Director/Trustee Three

BRITTANY HORNER
SECRETARY
217 BRIGHTON STREET
LOLO MT 59847

Organization’s website MEMORYLOSSLEGALSERVICE.ORG
Organization’s email HEATHER@MEMORYLOSSLEGALSERVICES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/7/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I80 - Legal 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 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 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 HEATHER CARNEVALE
Signature Title CHAIR
Signature Date 7/27/2021

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