FORM 1023-EZ for SURVIVING WITH GRACE INC

Field Data
EIN 47-4174967
Case Number EO-2015156-000177
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SURVIVING WITH GRACE INC
Organization’s Mailing Address 5168 SAVANNAH ST
City RAPID CITY
State SD
ZIP 57703
Accounting period End 12
Primary contact name TABATHA MURPHY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TABATHA MURPHY
PRESIDENT/DIRECTOR
5168 SAVANNAH ST
RAPID CITY SD 57703

Officer/Director/Trustee Two

TYLER MURPHY
DIRECTOR
5168 SAVANNAH ST
RAPID CITY SD 57703

Officer/Director/Trustee Three

ALYSSA HAWORTH
SECRETARY/DIRECTOR
2132 ELM AVE
RAPID CITY SD 57701

Officer/Director/Trustee Four

RHONDA SCHMIDT
DIRECTOR
5701 SATURN DR
RAPID CITY SD 57703

Officer/Director/Trustee Five

TYLER WOLF
TREASURER/DIRECTOR
625 36TH ST
RAPID CITY SD 57701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/5/2014
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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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