FORM 1023-EZ for SIEMBRA VIDA INC

Field Data
EIN 66-0824464
Case Number EO-2017237-000208
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SIEMBRA VIDA INC
Organization’s Mailing Address PO BOX 2030
City MAYAGUEZ
State PR
ZIP 00681
Accounting period End 12
Primary contact name JOSIAH HERNANDEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSIAH HERNANDEZ
PRESIDENT
PO BOX 2030
MAYAGUEZ PR 00681

Officer/Director/Trustee Two

DAHYANA TAMAYO
VICE-PRESIDENT
CALLE 308 1145
CABO ROJO PR 00623

Officer/Director/Trustee Three

SHANILIS ORTIZ
SECRETARY
406 VILLA FONTANA BO MIRADERO
MAYAGUEZ PR 00682

Officer/Director/Trustee Four

KENNETH RIVERA
TREASURER
PO BOX 2030
MAYAGUEZ PR 00681

Officer/Director/Trustee Five

ABRAHAM MONTES
MEMBER
789 J APONTE DE SILVA VILLA SULTANI
MAYAGUEZ PR 00680

Organization’s website SIEMBRAVIDA.ORG
Organization’s email SIEMBRAVIDA14@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/2014
Organization Incorporation State PR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: Yes
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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