FORM 1023-EZ for LATINX IN UROLOGY

Field Data
EIN 86-2468984
Case Number EO-2021103-000802
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LATINX IN UROLOGY
Organization’s Mailing Address 2118 SW 60TH AVE
City MIAMI
State FL
ZIP 33155
Accounting period End 12
Primary contact name JESSICA DELGADO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA DELGADO
PRESIDENT
2118 SW 60TH AVE
MIAMI FL 33155

Officer/Director/Trustee Two

KASSANDRA ZAILA
VICE PRESIDENT
2118 SW 60TH AVE
MIAMI FL 33155

Officer/Director/Trustee Three

YAHIR SANTIAGO-LASTRA
TREASURER
2118 SW 60TH AVE
MIAMI FL 33155

Officer/Director/Trustee Four

ELYSE CUSTUDIO
SECRETARY
2118 SW 60TH AVE
MIAMI FL 33155

Organization’s website
Organization’s email LATINXURO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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 JESSICA DELGADO
Signature Title PRESIDENT
Signature Date 4/6/2021

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