FORM 1023-EZ for FORT WORTH REPORT

Field Data
EIN 83-4688357
Case Number EO-2019133-000541
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FORT WORTH REPORT
Organization’s Mailing Address 201 MAIN STREET SUITE 2500
City FORT WORTH
State TX
ZIP 76102
Accounting period End 12
Primary contact name DANA STAYTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM MEADOWS
DIRECTOR; PRESIDENT
201 MAIN STREET SUITE 2500
FORT WORTH TX 76102

Officer/Director/Trustee Two

DANA STAYTON
DIRECTOR; SECRETARY
201 MAIN STREET SUITE 2500
FORT WORTH TX 76102

Officer/Director/Trustee Three

DEE STEER
DIRECTOR
201 MAIN STREET SUITE 2500
FORT WORTH TX 76102

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 DANA STAYTON
Signature Title DIRECTOR; SECRETARY
Signature Date 5/10/19

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