FORM 1023-EZ for MR FLORIDA RUBBER INC

Field Data
EIN 45-2803830
Case Number EO-2015058-000225
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MR FLORIDA RUBBER INC
Organization’s Mailing Address 2032 NW 10TH AVE
City FT LAUDERDALE
State FL
ZIP 33311
Accounting period End 12
Primary contact name ANDREW SEGALOFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JASON MACMENAMIN
DIRECTOR
2032 NW 10TH AVE
FT LAUDERDALE FL 33311

Officer/Director/Trustee Two

JASON PELKY
DIRECTOR
2032 NW 10TH AVE
FT LAUDERDALE FL 33311

Officer/Director/Trustee Three

ANDREW SEGALOFF
DIRECTOR
15775 89TH AVE N
PALM BEACH GARDENS FL 33418

Organization’s website WWW.MRFLORIDARUBBER.COM
Organization’s email INFO@MRFLORIDARUBBER.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/2011
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 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
Signature Title
Signature Date

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