FORM 1023-EZ for TEEN KICK

Field Data
EIN 82-4649960
Case Number EO-2018068-000157
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEEN KICK
Organization’s Mailing Address 4700 HWY 365 STE A PMB 21
City PORT ARTHUR
State TX
ZIP 77642-7719
Accounting period End 12
Primary contact name KISHA SIMMONS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KISHA SIMMONS
FOUNDER/CEO
5716 WHEATLEY AVE
PORT ARTHUR TX 77640-2345

Officer/Director/Trustee Two

LINDA STEWARD
PROGRAM MANAGER
3149 E 15TH ST
PORT ARTHUR TX 77642-4901

Officer/Director/Trustee Three

TIFFANY ROSS
COMMUNITY MANAGER
3333 TURTLE CREEK DR
PORT ARTHUR TX 77642-8099

Organization’s website HTTP://TEENKICKMINISTRIES.WIXSITE.COM/WEBSITE
Organization’s email TEENKICKMINISTRIES@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/5/18
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O22 - Girls Clubs
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
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 KISHA SIMMONS
Signature Title FOUNDER/CEO
Signature Date 3/7/18

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