FORM 1023-EZ for MIAMI SURF FIELD HOCKEY CLUB INC

Field Data
EIN 47-1250529
Case Number EO-2014311-000289
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MIAMI SURF FIELD HOCKEY CLUB INC
Organization’s Mailing Address 10181 NW 58TH STREET SUITE 12
City DORAL
State FL
ZIP 33178
Accounting period End 12
Primary contact name JELLE PRINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JELLE PRINS
CHAIR
1155 BRICKELL BAY DRIVE NO 1906
MIAMI FL 33131

Officer/Director/Trustee Two

ERYN APANOVITCH
VICE-CHAIR
720 COLLINS AVENUE APT 208
MIAMI BEACH FL 33139

Officer/Director/Trustee Three

HECTOR BLASO
CONSULTANT
945 NW 106TH AVENUE CIRCLE
MIAMI FL 33172

Organization’s website WWW.MIAMISURFFHC.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/14/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 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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