FORM 1023-EZ for POINT BREAK RECOVERY INC

Field Data
EIN 82-2339184
Case Number EO-2017268-000160
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POINT BREAK RECOVERY INC
Organization’s Mailing Address 5080 KINGSBURY ST
City JACKSONVILLE
State FL
ZIP 32205
Accounting period End 7
Primary contact name TINA SUMNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TINA SUMNER
VICE PRESIDENT
5080 KINGSBURY ST
JACKSONVILLE FL 32205

Officer/Director/Trustee Two

KRISTA WASKOSKI
DIRECTOR
5080 KINGSBURY ST
JACKSONVILLE FL 32205

Officer/Director/Trustee Three

HEATHER HOSMER
PRESIDENT
275 ISLANDER CIRCLE
ST AUGUSTINE FL 32080

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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