FORM 1023-EZ for REFLECT N IMAGE

Field Data
EIN 85-1489665
Case Number EO-2020225-000361
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REFLECT N IMAGE
Organization’s Mailing Address PO BOX 7823
City CHARLOTTE
State NC
ZIP 28241
Accounting period End 12
Primary contact name SHARRIKA BURNETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARRIKA BURNETT
FOUNDER EXECUTIVE OFFICER
PO BOX 7823
CHARLOTTE NC 28241

Officer/Director/Trustee Two

JAMES BURNETT
CEO
PO BOX 7823
CHARLOTTE NC 28241

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/22/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 SHARRIKA BURNETT
Signature Title CEO FOUNDER
Signature Date 8/10/2020

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