FORM 1023-EZ for YBS-YOUR BEST SELF

Field Data
EIN 82-2627397
Case Number EO-2017248-000375
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name YBS-YOUR BEST SELF
Organization’s Mailing Address 120 SYLVAN CT
City CIRCLEVILLE
State OH
ZIP 43113
Accounting period End 12
Primary contact name CARRIE MARTINEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARRIE MARTINEZ
PRESIDENT/FOUNDER
120 SYLVAN CT
CIRCLEVILLE OH 43113

Officer/Director/Trustee Two

ANDI BURROWS
TREASURER
587 OAKLAND TERRACE
CIRCLEVILLE OH 43113

Officer/Director/Trustee Three

WHITNEY QUEEN
SECRETARY
147 GRINER AVE
CIRCLEVILLE OH 43113

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/20/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, Services
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
Signature Title
Signature Date

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