FORM 1023-EZ for MOSAIC WELLNESS AND EDUCATION INC

Field Data
EIN 87-1419724
Case Number EO-2021223-000198
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOSAIC WELLNESS AND EDUCATION INC
Organization’s Mailing Address 454 NE 65 STREET
City MIAMI
State FL
ZIP 33138
Accounting period End 12
Primary contact name DAVID COLLURA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID COLLURA
PRESIDENT
6815 BISCAYNE BLVD UNIT 103-317
MIAMI FL 33138

Officer/Director/Trustee Two

ASHLEY MELIDOSIAN
SECRETARY
6815 BISCAYNE BLVD UNIT 103-317
MIAMI FL 33138

Officer/Director/Trustee Three

MARTIN AZAMBUYA
TREASURER
6815 BISCAYNE BLVD UNIT 103-317
MIAMI FL 33138

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/2021
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: 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 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 DAVID COLLURA
Signature Title PRESIDENT
Signature Date 8/9/2021

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