FORM 1023-EZ for COSTA RICA WATERFALL FOUNDATION INC

Field Data
EIN 82-5343781
Case Number EO-2018128-000222
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COSTA RICA WATERFALL FOUNDATION INC
Organization’s Mailing Address 10300 49TH ST N STE 423
City CLEARWATER
State FL
ZIP 33762
Accounting period End 12
Primary contact name DANIEL WELLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL WELLS
PRESIDENT, DIRECTOR
7100 ULMERTON BLVD LOT 607
LARGO FL 33771

Officer/Director/Trustee Two

KRISTY OGRADY
SECRETARY, DIRECTOR
848 N RAINBOW BLVD STE 891
LAS VEGAS NV 89107

Officer/Director/Trustee Three

JESSENIA VELASQUEZ
TREASURER, DIRECTOR
7100 ULMERTON BLVD LOT 607
LARGO FL 33771

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/16/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C99 - Environmental Quality, Protection, and Beautification N.E.C.
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 Yes
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 DANIEL WELLS
Signature Title PRESIDENT, DIRECTOR
Signature Date 4/30/18

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