FORM 1023-EZ for SHE SURVIVED I AM SHE INC

Field Data
EIN 87-1860383
Case Number EO-2021209-000386
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHE SURVIVED I AM SHE INC
Organization’s Mailing Address 10515 CHESTER AVENUE
City CLEVELAND
State OH
ZIP 44124
Accounting period End 12
Primary contact name SCHERETTA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA BULGIN
EXECUTIVE DIRECTOR
5674 SHAWNEE DRIVE
LYNDHURST OH 44124

Officer/Director/Trustee Two

DAVID COTTINGHAM
TRUSTEE 2
13309 SOUTH WOODLAND RD SUITE 5A
CLEVELAND OH 44120

Officer/Director/Trustee Three

ANGELICA WILLIAMS
TRUSTEE 3
4094 LOWDEN RD
SOUTH EUCLID OH 44121

Officer/Director/Trustee Four

CHRISTINE YARBORO
TRUSTEE 4
16002 CORKHILL RD
MAPLE HEIGHTS OH 44137

Officer/Director/Trustee Five

JAMIE ALLEN
TRUSTEE 5
8606 35TH AVE NE APT 209
SEATTLE WA 98115

Organization’s website
Organization’s email IAMSHESURVIVOR@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/8/2021
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 JESSICA BULGIN
Signature Title EXECUTIVE DIRECTOR
Signature Date 7/26/2021

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