FORM 1023-EZ for MUHAMMADS SHELTER INC

Field Data
EIN 83-4109133
Case Number EO-2019135-000137
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MUHAMMADS SHELTER INC
Organization’s Mailing Address 324 6TH AVE NORTH
City JACKSONVILLE BEACH
State FL
ZIP 32250
Accounting period End 12
Primary contact name BRANDON A MARESMA CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONALD MUHAMMAD
DIRECTOR
501 EAST CHURCH STREET
JACKSONVILLE FL 32202

Officer/Director/Trustee Two

ANDRE BRANCH
DIRECTOR
203 EAST 5TH STREET
JACKSONVILLE FL 32206

Officer/Director/Trustee Three

THOMAS MORMAN
DIRECTOR
12611 ANGEL LAKE DRIVE W
JACKSONVILLE FL 32218

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/3/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 Yes
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 DONALD MUHAMMAD
Signature Title DIRECTOR
Signature Date 5/13/19

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