FORM 1023-EZ for FAMILY RESTORATION SERVICES INC

Field Data
EIN 83-3558785
Case Number EO-2019079-000476
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FAMILY RESTORATION SERVICES INC
Organization’s Mailing Address 537 VINELAND DR
City JACKSON
State MS
ZIP 39212
Accounting period End 12
Primary contact name VALERIE JENKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VALERIE JENKINS
PRESIDENT
537 VINELAND DR
JACKSON MS 39212

Officer/Director/Trustee Two

ANGELA MCKENNY
VICE PRESIDENT
201 RAMADA CIR
JACKSON MS 39212

Officer/Director/Trustee Three

KIMBERLY BEVERLY
SECRETARY
1529 VERNON CIR
JACKSON MS 39204

Officer/Director/Trustee Four

CATINA BUTLER
TREASURER
1006 WINDMILL DR
BYRAM MS 39272

Officer/Director/Trustee Five

DEBORAH BLAND
BOARD ADVISOR
4105 SWAN HILL DR
JACKSON MS 39212

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/19
Organization Incorporation State MS
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 Yes
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 VALERIE JENKINS
Signature Title PRESIDENT
Signature Date 3/18/19

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