FORM 1023-EZ for SIMPLY GIVE BACK INC

Field Data
EIN 45-2449279
Case Number EO-2016148-000113
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SIMPLY GIVE BACK INC
Organization’s Mailing Address PO BOX 3292
City GRAPEVINE
State TX
ZIP 76099
Accounting period End 12
Primary contact name CANDACE DELAINE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CANDACE DELAINE
PRESIDENT
PO BOX 3292
GRAPEVINE TX 76099

Officer/Director/Trustee Two

XANTHIA SETTLE
VICE PRESIDENT
4012 SOUTHBROOK COURT NW
KENNESAW GA 30152

Officer/Director/Trustee Three

ANDREA RELIFORD
SECRETARY
5150 YORKSHIRE DRIVE
PINSON AL 35126

Organization’s website WWW.SIMPLYGIVEBACK.ORG
Organization’s email SIMPLYGIVEBACK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2011
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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