FORM 1023-EZ for YOUTH IN-2-ACTION PROGRAM

Field Data
EIN 47-1531174
Case Number EO-2014245-000376
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name YOUTH IN-2-ACTION PROGRAM
Organization’s Mailing Address 201 TOULON CT
City FAIRVIEW HEIGHTS
State IL
ZIP 62208
Accounting period End 12
Primary contact name DERRICK KING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DERRICK KING
PRESIDENT
201 TOULON CT
FAIRVIEW HTS IL 62208

Officer/Director/Trustee Two

TARA PHELPS-JONES
SECRETARY
201 BAYBERRY DR
FAIRVIEW HTS IL 62208

Officer/Director/Trustee Three

JEFFREY WILLIAMS
TREASURER
1024 NEW BRITAIN CT
O'FALLON IL 62269

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/13/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
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 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
Signature Title
Signature Date

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