FORM 1023-EZ for CCJ HERRERA FOUNDATION INC

Field Data
EIN 87-0913073
Case Number EO-2021152-000647
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CCJ HERRERA FOUNDATION INC
Organization’s Mailing Address 14400 NW 77TH COURT SUITE 300
City MIAMI LAKES
State FL
ZIP 33016
Accounting period End 12
Primary contact name MARK HASNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARLOS HERRERA JR
PSD
14400 NW 77TH COURT SUITE 300
MIAMI LAKES FL 33016

Officer/Director/Trustee Two

ALBERTO VALENCIA
VPTD
14400 NW 77TH COURT SUITE 300
MIAMI LAKES FL 33016

Officer/Director/Trustee Three

MAURICIO CAYON
D
7480 SW 40TH STREET SUITE 700
MIAMI FL 33155

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/25/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 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 CARLOS HERRERA JR
Signature Title PSD
Signature Date 5/28/2021

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