FORM 1023-EZ for CLEEN ENVIRONMENTAL SERVICES INC

Field Data
EIN 83-4192508
Case Number EO-2019093-000189
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLEEN ENVIRONMENTAL SERVICES INC
Organization’s Mailing Address 25 W CRYSTAL LAKE ST STE 157
City ORLANDO
State FL
ZIP 32806
Accounting period End 12
Primary contact name ANDIS DIAZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDIS DIAZ
PRESIDENT
7010 LAKE NONA BLVD 409
ORLANDO FL 32827

Officer/Director/Trustee Two

TIM MOON
VP
9969 DOWDEN RD 13118
ORLANDO FL 32832

Officer/Director/Trustee Three

MARILUZ RIVERA
SECRETARY
100 W GRANT ST 5028
ORLANDO FL 32806

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/18/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C27 - Recycling Programs
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 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 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 ANDIS DIAZ
Signature Title PRESIDENT
Signature Date 4/1/19

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