FORM 1023-EZ for ANNE MIMOSE MONDELUS R FOUNDATION

Field Data
EIN 82-4201860
Case Number EO-2018109-000750
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANNE MIMOSE MONDELUS R FOUNDATION
Organization’s Mailing Address 4808 SERAFICA DRIVE
City LAKE WORTH
State FL
ZIP 33461
Accounting period End 12
Primary contact name ANNE MIMOSE MONDELUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANNE MIMOSE MONDELUS
PRESIDENT
4808 SERAFICA DRIVE
LAKE WORTH FL 33461

Officer/Director/Trustee Two

PIERREJUDE MONDELUS
VP
4808 SERAFICA DRIVE
LAKE WORTH FL 33461

Officer/Director/Trustee Three

JEAN RONY RENARD
VP
4808 SERAFICA DRIVE
LAKE WORTH FL 33461

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
Organization’s purpose Charitable: Yes
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 ANNE MIMOSE MONDELUS
Signature Title PRESIDENT
Signature Date 4/17/18

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