FORM 1023-EZ for BREAD FROM THE VINE INC

Field Data
EIN 82-4579952
Case Number EO-2018186-000476
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BREAD FROM THE VINE INC
Organization’s Mailing Address 4141 NW 47TH TERRACE
City LAUDERDALE LAKES
State FL
ZIP 33319
Accounting period End 12
Primary contact name RAQUEL ANDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RAQUEL ANDERSON
PRESIDENT AND DIRECTOR
4141 NW 47 TERRACE
LAUDERDALE LAKES FL 33319

Officer/Director/Trustee Two

NEMA SMITH
VICE PRESIDENT AND DIRECTOR
5451 N STATE ROAD 7 UNIT 590932
FORT LAUDERDALE FL 33359

Officer/Director/Trustee Three

ROSHELL BROWN
SECRETARY AND DIRECTOR
5451 N STATE ROAD 7 UNIT 590932
FORT LAUDERDALE FL 33359

Officer/Director/Trustee Four

KAYLA PEART
TREASURER
5451 N STATE ROAD 7 UNIT 590932
FORT LAUDERDALE FL 33359

Officer/Director/Trustee Five

CARL BENJAMIN
OFFICER
5451 N STATE ROAD 7 UNIT
FORT LAUDERDALE FL 33359

Organization’s website
Organization’s email BREADFROMTHEVINE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/12/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 RAQUEL ANDERSON
Signature Title PRESIDENT AND DIRECTOR
Signature Date 7/3/18

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