FORM 1023-EZ for A BREAK FOR GRANDMOTHERS

Field Data
EIN 81-2259424
Case Number EO-2016256-000345
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name A BREAK FOR GRANDMOTHERS
Organization’s Mailing Address P O BOX 764371
City DALLAS
State TX
ZIP 75376
Accounting period End 12
Primary contact name ARVELLA WARREN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ARVELLA WARREN
PRESIDENT/TREASURER
4931 JADE DRIVE
DALLAS TX 75232

Officer/Director/Trustee Two

MARY WESLEY
VICE PRESIDENT
2312 GIBBS WILLIAMS CIRCLE
DALLAS TX 75224

Officer/Director/Trustee Three

ROSLYN SUTTON
SECRETARY
5921 MARBLEHEAD DRIVE
DALLAS TX 75232

Officer/Director/Trustee Four

JETTA EWELLS
BOARD MEMBER
332 TREES DRIVE
CEDAR HILL TX 75104

Officer/Director/Trustee Five

JACQUELINE HARRIS
BOARD MEMBER
1330 SAN MIGUEL
DUNCANVILLE TX 75137

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/4/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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