FORM 1023-EZ for INTEGRATED YOUTH SERVIES INC

Field Data
EIN 83-0952042
Case Number EO-2019036-001051
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INTEGRATED YOUTH SERVIES INC
Organization’s Mailing Address 6901 SALEWSKY CT
City ELK GOVE
State CA
ZIP 95757
Accounting period End 12
Primary contact name LANEISHA JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CEMETRA TYSON
CEO
6901 SALEWSKY CT
ELK GROVE CA 95757

Officer/Director/Trustee Two

LANEISHA JONES
SECRETARY
6901 SALEWSKY CT
ELK GROVE CA 95757

Officer/Director/Trustee Three

LANEISHA JONES
CFO
6901 SALEWSKY CT
ELK GROVE CA 95757

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F33 - Group Home, Residential Treatment Facility - Mental Health Related
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 LANEISHA JONES
Signature Title CFO
Signature Date 1/22/19

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