FORM 1023-EZ for GENESIS YOUTH SERVICES INC
| Field | Data |
|---|---|
| EIN | 81-3690096 |
| Case Number | EO-2020073-000367 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | GENESIS YOUTH SERVICES INC |
| Organization’s Mailing Address | 14286 BEACH BLVD STE 19-121 |
| City | JACKSONVILLE BEACH |
| State | FL |
| ZIP | 32250 |
| Accounting period End | 12 |
| Primary contact name | MARK FARR |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MARK FARR
DIRECTOR
49676 CRANBROOK DRIVE
MACOMB MI 48044
Officer/Director/Trustee Two
KEIA FARR
DIRECTOR
49676 CRANBROOK DRIVE
MACOMB MI 48044
Officer/Director/Trustee Three
EURMON HERVEY
DIRECTOR
2333 THE WOODS DR WEST
JACKSONVILLE FL 32246
Officer/Director/Trustee Four
MELINDA POWERS
DIRECTOR
5845 BARTRAM CIRCLE NORTH
JACKSOVILLE FL 32207
Officer/Director/Trustee Five
KEN JEFFERSON
DIRECTOR
14286 BEACH BLVD STE 19-121
JACKSOVILLE FL 32250
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/9/2016 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | O20 - Youth Centers, Clubs, Multipurpose |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No 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 | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | MARK FARR |
| Signature Title | DIRECTOR |
| Signature Date | 3/11/2020 |
| EIN | 81-3690096 |
| Case Number | EO-2016263-000488 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | GENESIS YOUTH SERVICES INC |
| Organization’s Mailing Address | 14286 BEACH BOULEVARD SUITE 19-121 |
| City | JACKSONVILLE |
| State | FL |
| ZIP | 32250 |
| Accounting period End | 9 |
| Primary contact name | MARK FARR |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MARK FARR
CEO
14286 BEACH BOULEVARD SUITE 19-121
JACKSONVILLE FL 32250
Officer/Director/Trustee Two
EURMON HERVEY
DIRECTOR
2333 THE WOODS DRIVE WEST
JACKSONVILLE FL 32246
Officer/Director/Trustee Three
DETRIA DUKES
DIRECTOR
6000 BARTRAM VILLAGE DRIVE
JACKSONVILLE FL 32258
Officer/Director/Trustee Four
KEIA FARR
DIRECTOR
14286 BEACH BOULEVARD SUITE 19-121
JACKSONVILLE FL 32250
Officer/Director/Trustee Five
MELINDA POWERS
DIRECTOR
5845 BARTRAM CIRCLE NORTH
JACKSONVILLE FL 32207
| Organization’s website | WWW.GYS4U.COM |
|---|---|
| Organization’s email | INFO@GYS4U.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/9/2016 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | I44 - Prison Alternatives |
| 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 | 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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