FORM 1023-EZ for PLANT-BASED BREVARD INC

Field Data
EIN 83-4567919
Case Number EO-2019121-000105
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PLANT-BASED BREVARD INC
Organization’s Mailing Address 1030 STEVEN PATRICK AVE
City INDIAN HARBOUR BEACH
State FL
ZIP 32937-4276
Accounting period End 12
Primary contact name KEENUN BARLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEENUN BARLEY
PRESIDENT
1030 STEVEN PATRICK AVE
INDIAN HARBOUR BEACH FL 32937-4276

Officer/Director/Trustee Two

JULIE PERRY
VICE PRESIDENT
2325 OAKRIDGE LANE
MALABAR FL 32950-3501

Officer/Director/Trustee Three

CASIE FARRELL
DIRECTOR
873 HORIZON RD SE
PALM BAY FL 32909-4911

Officer/Director/Trustee Four

COURTNIE LOVE
DIRECTOR
5374 CRANE ROAD
MELBOURNE FL 32904-2548

Officer/Director/Trustee Five

KELLIE BOWLING
DIRECTOR
5050 S HWY A1A
MELBOURNE BEACH FL 32951-3207

Organization’s website WWW.PLANTBASEDBREVARD.COM
Organization’s email KEENUN@PLANTBASEDBREVARD.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/25/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
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 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 KEENUN BARLEY
Signature Title PRESIDENT
Signature Date 4/29/19

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