FORM 1023-EZ for SHEPHERDS 5-R FOUNDATION

Field Data
EIN 83-2099808
Case Number EO-2019029-000497
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHEPHERDS 5-R FOUNDATION
Organization’s Mailing Address PO BOX 248
City MARION
State AR
ZIP 72364
Accounting period End 10
Primary contact name TIARA MEACHAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIARA MEACHAM
PRESIDENT
PO BOX 248
MARION AR 72364

Officer/Director/Trustee Two

HEROD SHEPHERD
VICE PRESIDENT
P O BOX 248
MARION AR 72364

Officer/Director/Trustee Three

DEKIMBERLY BUTLER
TREASURER
P O BOX 248
MARION AR 72364

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/3/18
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: Yes
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 TIARA MEACHAM
Signature Title PRESIDENT
Signature Date 12/21/18

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