FORM 1023-EZ for UNIQUE AFFIRMATION FOUNDATION INC

Field Data
EIN 82-5165369
Case Number EO-2018197-000539
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name UNIQUE AFFIRMATION FOUNDATION INC
Organization’s Mailing Address 3322 WEST SOUTH STREET
City ORLANDO
State FL
ZIP 32805
Accounting period End 12
Primary contact name LYSCHELLE HOLLAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LYSCHELLE HOLLAND
PRESIDENT
3322 WEST SOUTH STREET
ORLANDO FL 32805

Officer/Director/Trustee Two

GAY HOLLAND
VICE PRESIDENT
3322 WEST SOUTH STREET
ORLANDO FL 32805

Officer/Director/Trustee Three

NATASHA MOORE
MEMBER
15563 MERLIN AVENUE
MASCOTTE FL 34753

Officer/Director/Trustee Four

HOPE ELLIOTT
MEMBER
785 W LANCASTER RD C45
ORLANDO FL 32809

Officer/Director/Trustee Five

MICHELLE RIVERA VICIOSO
MEMBER
4581 EDGEMOOR STREET
ORLANDO FL 32811

Organization’s website
Organization’s email UNIQUEAFFIRMATIONFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/20/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
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 LYSCHELLE HOLLAND
Signature Title PRESIDENT
Signature Date 7/14/18

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