FORM 1023-EZ for AQUA BY JESSE FOUNDATION

Field Data
EIN 87-2864825
Case Number EO-2021274-000170
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AQUA BY JESSE FOUNDATION
Organization’s Mailing Address 987 SW 37TH AVE APT 1103
City MIAMI
State FL
ZIP 33135
Accounting period End 12
Primary contact name JESSICA ROTELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA ROTELL
DIRECTOR
987 SW 37TH AVE APT 1103
MIAMI FL 33135

Officer/Director/Trustee Two

RAFAEL ORRACA
OFFICER
115 SW 11TH ST
MIAMI FL 33130

Officer/Director/Trustee Three

LAKE MCCROSSIN
OFFICER
5351 SW 57TH ST
DAVIE FL 33314

Organization’s website AQUABYJESSE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/29/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 JESSICA ROTELL
Signature Title DIRECTOR
Signature Date 9/29/2021

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