FORM 1023-EZ for SULLIVANS SMILES FOUNDATION

Field Data
EIN 83-0785440
Case Number EO-2018208-000183
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SULLIVANS SMILES FOUNDATION
Organization’s Mailing Address 225 TIMBERLAKE DR
City AZLE
State TX
ZIP 76020
Accounting period End 12
Primary contact name TAMARA NORWOOD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMARA NORWOOD
PRESIDENT
225 TIMBERLAKE DR
AZLE TX 76020

Officer/Director/Trustee Two

IVY NORWOOD
VICE PRESIDENT
5113 GOLDEN LN
FORT WORTH TX 76123

Officer/Director/Trustee Three

LAUREN BREAK
SECRETARY
1100 USHER ST
BENBROOK TX 76126

Organization’s website WWW.SULLIVANSSMILE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/24/18
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G20 - Birth Defects and Genetic Diseases
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TAMARA NORWOOD
Signature Title PRESIDENT
Signature Date 7/25/18

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