FORM 1023-EZ for I AM 195 INC

Field Data
EIN 85-3539023
Case Number EO-2021035-000091
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name I AM 195 INC
Organization’s Mailing Address 1530 P B LN SUITE G4795
City WICHITA FALLS
State TX
ZIP 76302-2612
Accounting period End 12
Primary contact name ANDREW ROMAN PRESIDENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW ROMAN
PRESIDENT
1585 17TH CT SW
VERO BEACH FL 32962

Officer/Director/Trustee Two

PATRICK YOUNGQUIST
SECRETARY
1585 17TH CT SW
VERO BEACH FL 32962

Officer/Director/Trustee Three

DERREK BAGBY
TREASURER
1585 17TH CT SW
VERO BEACH FL 32962

Organization’s website
Organization’s email 5612828716@NPHZ.EMAIL
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ANDREW ROMAN
Signature Title PRESIDENT
Signature Date 12/19/2020

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