FORM 1023-EZ for ANNABELLE S AMAZING GRACES

Field Data
EIN 83-2828625
Case Number EO-2019071-000735
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANNABELLE S AMAZING GRACES
Organization’s Mailing Address 3818 TEAL BAY LANE
City FULSHEAR
State TX
ZIP 77441-1871
Accounting period End 12
Primary contact name SHELLEY VAN DEURSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHELLEY VAN DEURSEN
CHAIRMAN
3818 TEAL BAY LANE
FULSHEAR TX 77441-1871

Officer/Director/Trustee Two

DANIEL VAN DEURSEN
EXECUTIVE DIRECTOR & PRESIDENT
3818 TEAL BAY LANE
FULSHEAR TX 77441-1871

Officer/Director/Trustee Three

CONNIE ROGGE
DIRECTOR
1011 PLANTATION MEADOWS
RICHMOND TX 77406-2513

Organization’s website HTTP://ANNABELLESAMAZINGGRACES.ORG
Organization’s email SHELLEY@ANNABELLESAMAZINGGRACES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/3/18
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G12 - Fund Raising and/or Fund Distribution
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 SHELLEY VAN DEURSEN
Signature Title CHAIRMAN
Signature Date 3/7/19

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