FORM 1023-EZ for PRIMERA IGLESIA BAUTISTA HISPANA FEINC

Field Data
EIN 26-3484435
Case Number EO-2015096-000295
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PRIMERA IGLESIA BAUTISTA HISPANA FEINC
Organization’s Mailing Address 148 HOLMES AVENUE
City LAKE PLACID
State FL
ZIP 33852
Accounting period End 9
Primary contact name EUGENIO RODRIGUEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

OMAR MEDINA
PRESIDENT
MAIN STREET 150
LAKE PLACID FL 33852-5255

Officer/Director/Trustee Two

EUGENIO RODRIGUEZ
TREASURE
248 BLUEMOON AVE
LAKE PLACID FL 33852-5255

Officer/Director/Trustee Three

TABITA RIVERA
SECRETARY
229 TULIP DR
LAKE PLACID FL 33852-5255

Officer/Director/Trustee Four

AURA MORENO
VICP
116 IDA AVE
LAKE PLACID FL 33852

Officer/Director/Trustee Five

VICTOR M RODRIGUEZ
TRUS
100 IDA AVE
LAKE PLACID FL 33852

Organization’s website
Organization’s email PIBHFELP@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2008
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X21 - Protestant
Organization’s purpose Charitable: No
Religious: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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