FORM 1023-EZ for MIXED IN AMERICA INC

Field Data
EIN 84-2339558
Case Number EO-2019310-000265
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIXED IN AMERICA INC
Organization’s Mailing Address 420 MELROSE ST APT 1R
City BROOKLYN
State NY
ZIP 11237
Accounting period End 12
Primary contact name JAZMINE JARVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAZMINE JARVIS
CO-PRESIDENT
4650 N RAINBOW BLVD APT 1084
LAS VEGAS NV 89108

Officer/Director/Trustee Two

MEAGAN SMITH
CO-PRESIDENT
420 MELROSE ST APT 1R
BROOKLYN NY 11237

Officer/Director/Trustee Three

LORENZO JARVIS
SECRETARY/TREASURER
608 SUMMIT VALLEY LN
HENDERSON NV 89011

Organization’s website WWW.MIXEDINAMERICA.ORG
Organization’s email INFO@MIXEDINAMERICA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/19
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
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 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 JAZMINE JARVIS
Signature Title CO-PRESIDENT
Signature Date 11/4/19

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