FORM 1023-EZ for SURVIVE FIRST

Field Data
EIN 82-4898523
Case Number EO-2018117-000059
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SURVIVE FIRST
Organization’s Mailing Address 131 OAK AVE
City COCOA BEACH
State FL
ZIP 32931
Accounting period End 12
Primary contact name DOUGLAS MONDA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOUGLAS MONDA
DIRECTOR/PRESIDENT
131 OAK AVE
COCOA BEACH FL 32931

Officer/Director/Trustee Two

KAREN MONDA
DIRECTOR/SECRETARY
131 OAK AVE
COCOA BEACH FL 32931

Officer/Director/Trustee Three

ALFRED BOETTJER
DIRECTOR
1000 GALLEON ST
COCOA FL 32927

Officer/Director/Trustee Four

DOUGLAS MULDOON
DIRECTOR
1504 KNOLL RIDGE DR
COCOA FL 32940

Officer/Director/Trustee Five

DOW JONES
DIRECTOR
2 FALCONWOOD LANE
SANDY UT 84092

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/11/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
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 Yes
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 DOUGLAS MONDA
Signature Title DIRECTOR/PRESIDENT
Signature Date 4/25/18

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