FORM 1023-EZ for DIVETHERAPY

Field Data
EIN 83-0549210
Case Number EO-2018187-000314
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DIVETHERAPY
Organization’s Mailing Address 1103 DEER SPRINGS RD
City PORT ORANGE
State FL
ZIP 32129
Accounting period End 12
Primary contact name JAMES MAXWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES MAXWELL
CEO
1103 DEER SPRINGS RD
PORT ORANGE FL 32129

Officer/Director/Trustee Two

JASON MICKELSON
DIRECTOR
7703 NORTH BLVD
FORT PIERCE FL 34951

Officer/Director/Trustee Three

TIFFANY HERRERA
DIRECTOR
1103 DEER SPRINGS RD
PORT ORANGE FL 32129

Organization’s website WWW.VETDIVETHERAPY.COM
Organization’s email DIVETHERAPYINC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/9/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAMES MAXWELL
Signature Title CEO
Signature Date 7/4/18

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