FORM 1023-EZ for GISELLE MARIE FOUNDATION

Field Data
EIN 47-2131120
Case Number EO-2015069-000838
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GISELLE MARIE FOUNDATION
Organization’s Mailing Address 2910 KERRY FOREST PKWY D4 302
City TALLAHASSEE
State FL
ZIP 32309
Accounting period End 12
Primary contact name DAVID MEDINA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVID MEDINA
FOUNDER
2910 KERRY FOREST PKWY D4 302
TALLAHASSEE FL 32309

Officer/Director/Trustee Two

GISELA RODRIGUEZ
CO-FOUNDER
2910 KERRY FOREST PKWY D4 302
TALLAHASSEE FL 32309

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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