FORM 1023-EZ for PROSPECT LAB INC

Field Data
EIN 86-3988490
Case Number EO-2021144-000107
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROSPECT LAB INC
Organization’s Mailing Address 12515 HIDDEN DR
City JACKSONVILLE
State FL
ZIP 32225
Accounting period End 12
Primary contact name VICTORIA HARDIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VICTORIA HARDIN
REGISTERED AGENT
12515 HIDDEN DR
JACKSONVILLE FL 32225

Officer/Director/Trustee Two

DERRICK MCCANTS
DIRECTOR
12847 LACOSTA COURT
JACKSONVILLE FL 32225

Officer/Director/Trustee Three

CHRISTOPHER MATTHEWS
DIRECTOR
10935 HOUNDWELL WAY
JACKSONVILLE FL 32225

Officer/Director/Trustee Four

AMOS RILEY JR
DIRECTOR
1524 MONUMENT OAKS DR
JACKSONVILLE FL 32225

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/20/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N63 - Baseball, Softball
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name VICTORIA HARDIN
Signature Title REGISTERED AGENT
Signature Date 5/21/2021

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