FORM 1023-EZ for FLORIDA WILDLIFE HABITAT REHAB INC

Field Data
EIN 84-3946163
Case Number EO-2019360-000423
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FLORIDA WILDLIFE HABITAT REHAB INC
Organization’s Mailing Address 4417 JACKSON ST
City MARIANNA
State FL
ZIP 32448
Accounting period End 12
Primary contact name CHARLES UNKLE III
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES UNKLE III
PRESIDENT
6609 THOMAS DR
PANAMA CITY BEACH FL 32408

Officer/Director/Trustee Two

ALEX PRIETO
VICE PRESIDENT
4417 JACKSON ST
MARIANNA FL 32408

Officer/Director/Trustee Three

BETH VANDERWOUDE
SECRATARY
4417 JACKSON ST
MARIANNA FL 32448

Officer/Director/Trustee Four

VANESSA MORILLO
MARKETING DIRECTORRATARY
4417 JACKSON ST
MARIANNA FL 32448

Organization’s website 4X4H2O.COM
Organization’s email C.UNKLE@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/25/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - 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 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 CHARLES UNKLE III
Signature Title PRESIDENT
Signature Date 12/24/2019

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