FORM 1023-EZ for SYMB1OSIS

Field Data
EIN 87-1219408
Case Number EO-2021200-000531
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SYMB1OSIS
Organization’s Mailing Address 5080 DEQUINCEY DR
City FAIRFAX
State VA
ZIP 22032
Accounting period End 12
Primary contact name GRACE WATKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GRACE WATKINS
PRESIDENT DIRECTOR
5080 DEQUINCEY DR
FAIRFAX VA 22032

Officer/Director/Trustee Two

BAILEY JONES
SECRETARY DIRECTOR
10226 GROVEWOOD WAY
FAIRFAX VA 22032

Officer/Director/Trustee Three

SUSAN HERNANDEZ
TREASURER DIRECTOR
487 NELSON DR APT 10
NEWPORT NEWS VA 23601

Officer/Director/Trustee Four

NYA WATERS
DIRECTOR
2245 UNIV STES DR APT F
GREENVILLE NC 27858

Organization’s website WWW.SYMB1OSIS.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/30/2021
Organization Incorporation State VA
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: Yes
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 Yes
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 GRACE WATKINS
Signature Title PRESIDENT DIRECTOR
Signature Date 7/16/2021

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