FORM 1023-EZ for SURVIVAL SKILLS INSTITUTE

Field Data
EIN 41-1351176
Case Number EO-2018288-000319
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SURVIVAL SKILLS INSTITUTE
Organization’s Mailing Address PO BOX 11142
City MINNEAPOLIS
State MN
ZIP 55411
Accounting period End 12
Primary contact name BARRY ROGERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GERALDINE JOHNSON-CARTER
BOARD CHAIR
12005 41ST AVE NORTH 317
PLYMOUTH MN 55441

Officer/Director/Trustee Two

DOROTHY JOHNSON-MOORE
VICE CHAIR
2407 UNITY AVE NORTH
GOLDEN VALLEY MN 55422

Officer/Director/Trustee Three

GLADYS RANDLE
TREASURER
1801 OLIVER AVE NORTH
MINNEAPOLIS MN 55411

Officer/Director/Trustee Four

CHARLENE CRITTENDED
SECRETARY
1706 HILLSIDE AVE NORTH
MINNEAPOLIS MN 55411

Officer/Director/Trustee Five

WILMA LAWRENCE
BOARD MEMBER
1510 11TH AVE SOUTH 804
MINNEAPOLIS MN 55404

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/27/78
Organization Incorporation State MN
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: 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 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 GERALDINE JOHNSON-CARTER
Signature Title BOARD CHAIR
Signature Date 10/11/18

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