FORM 1023-EZ for BEAUTIFULLY BROKEN INCORPORATED

Field Data
EIN 83-2064862
Case Number EO-2019039-000541
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BEAUTIFULLY BROKEN INCORPORATED
Organization’s Mailing Address 6605 WICKED OAK LANE
City CHARLOTTE
State NC
ZIP 28216-8838
Accounting period End 12
Primary contact name CRYSTAL REID
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CRYSTAL REID
PRESIDENT
6625 WICKED OAK LANE
CHARLOTTE NC 28216-8838

Officer/Director/Trustee Two

LATOYA JOHNOSN
BOARD MEMBER
3317 BRADEN DR
CHARLOTTE NC 28216-3064

Officer/Director/Trustee Three

MAYA FREDRICK
BOARD MEMBER
1911 WINDY WILLOW LANE
DALLAS NC 28034-267

Officer/Director/Trustee Four

LEAH REID
SECRETARY
6625 WICKED OAK LANE
CHARLOTTE NC 28216-8838

Officer/Director/Trustee Five

LAWUISH WARNE
BOARD MEMBER
3317 BRADEN DR
CHARLOTTE NC 28216-3064

Organization’s website
Organization’s email CREID81508@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/4/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CRYSTAL REID
Signature Title PRESIDENT
Signature Date 2/4/19

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