FORM 1023-EZ for REBELLUTION INC

Field Data
EIN 82-1471205
Case Number EO-2017152-000345
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name REBELLUTION INC
Organization’s Mailing Address 3107 DOGWOOD LANE
City MARGATE
State FL
ZIP 33063-8018
Accounting period End 11
Primary contact name AMBROSIA TORO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMBROSIA TORO
CEO
3107 DOGWOOD LANE
MARGATE FL 33063-8018

Officer/Director/Trustee Two

KRISTIN BERRY
COO
2851 E GOLF BOULEVARD APT 206
POMPANO BEACH FL 33064-3761

Officer/Director/Trustee Three

JOSEY FLOWERS
CFO
261 NW 48TH STREET
FORT LAUDERDALE FL 33309-4062

Officer/Director/Trustee Four

ROBERT PINERA
BOARD PRESIDENT
101 NE 48TH COURT
OAKLAND PARK FL 33334-1513

Officer/Director/Trustee Five

KATHY CHAPMAN
BOARD VICE PRESIDENT
3199 BAYBERRY WAY
MARGATE FL 33063-8018

Organization’s website REBELLUTION.LIFE
Organization’s email REBELLUTION.LIFE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/30/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X80 - Religious Media, Communications Organizations
Organization’s purpose Charitable: Yes
Religious: Yes
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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