FORM 1023-EZ for JACKS BOX

Field Data
EIN 84-1971601
Case Number EO-2019157-000303
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JACKS BOX
Organization’s Mailing Address 525 12TH AVE N
City GREYBULL
State WY
ZIP 82426
Accounting period End 12
Primary contact name MISTY PHARAOH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACK PHARAOH
CEO
525 12TH AVE N
GREYBULL WY 82426

Officer/Director/Trustee Two

MISTY PHARAOH
DIRECTOR
525 12TH AVE N
GREYBULL WY 82426

Officer/Director/Trustee Three

RACHELL WILCOX
TRUSTEE
801 8TH AVE N
GREYBULL WY 82426

Officer/Director/Trustee Four

COLE WILCOX
TRUSTEE
801 8TH AVE N
GREYBULL WY 82426

Officer/Director/Trustee Five

SAMANTHA COOK
TRUSTEE
3505 ROAD 28
GREYBULL WY 82426

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/26/17
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other 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 Yes
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 MISTY PHARAOH
Signature Title DIRECTOR
Signature Date 6/4/19

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