FORM 1023-EZ for JACK SIMS SHOE FOUNDATION

Field Data
EIN 27-4477794
Case Number EO-2017009-000265
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JACK SIMS SHOE FOUNDATION
Organization’s Mailing Address 6615 ELMHURST STREET
City DISTRICT HEIGHTS
State MD
ZIP 20747
Accounting period End 12
Primary contact name JACK SIMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACK SIMS
PRESIDENT
6615 ELMHURST STREET
DISTRICT HEIGHTS MD 20747

Officer/Director/Trustee Two

PAM NELSON
BOARD MEMBER
8410 SOUTH KENWOOD
CHICAGO IL 60619

Officer/Director/Trustee Three

JUSTIN SIMS
BOARD MEMBER
6615 ELMHURST STREET
DISTRICT HEIGHTS MD 20747

Officer/Director/Trustee Four

DEBORAH DELGADO
BOARD MEMBER
304 WILLIAMS STREET
HATTIESBURG MD 39403

Officer/Director/Trustee Five

EARL SORRELL
BOARD MEMBER
7174 LOOKOUT COURT
LIBERTY TOWNSHIP OH 45011

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/12/2014
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O53 - Youth Development - Business
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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