FORM 1023-EZ for XSPURT PROVIDER SERVICES

Field Data
EIN 65-1035653
Case Number EO-2016348-000344
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name XSPURT PROVIDER SERVICES
Organization’s Mailing Address 6283 NW 201 TERRACE SUITE 2A
City HIALEAH
State FL
ZIP 33015
Accounting period End 12
Primary contact name LINDA WASHINGTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LINDA WASHINGTON
PRESIDENT
6283 NW 201 TERRACE
HIALEAH FL 33015

Officer/Director/Trustee Two

EDWARD BROWN
V PRESIDENT
2443 NW 179TH STREET
MIAMI GARDENS FL 33056

Officer/Director/Trustee Three

LARECHIA BELL
SECRETARY
266 NW 47TH TERRACE
DEERFIELD FL 33442

Officer/Director/Trustee Four

LARRY WASHINGTON JR
TREASURER
19808 NW 33RD COURT
MIAMI GARDENS FL 33056

Organization’s website XSPURTPROVIDERSERVICES.COM
Organization’s email XSPURTPROVIDERSERVICES@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/8/1999
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B60 - Adult, Continuing Education
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
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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