FORM 1023-EZ for ENCEPHALITIS411

Field Data
EIN 82-2137197
Case Number EO-2017198-000486
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ENCEPHALITIS411
Organization’s Mailing Address 3617 PENNSYLVANIA LN
City PLANO
State TX
ZIP 75075
Accounting period End 12
Primary contact name REBECCA DENNIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REBECCA DENNIS
PRESIDENT
3617 PENNSYLVANIA LN
PLANO TX 75075

Officer/Director/Trustee Two

ROBERT M
SECRETARY
601 ALHAMBRA LN NORTH
PONTE VEDRA BEACH FL 32082

Officer/Director/Trustee Three

NANCY STEPHENS
TREASURER
5000 HILLSBORO PIKE H-7
NASHVILLE TN 37215

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/2017
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H48 - Brain Disorders Research
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
Signature Title
Signature Date

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