FORM 1023-EZ for KEVIN SPECIAL PALS

Field Data
EIN 47-4951469
Case Number EO-2015264-000383
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KEVIN SPECIAL PALS
Organization’s Mailing Address 12618 MIRIAM LANE
City HOUSTON
State TX
ZIP 77071
Accounting period End 12
Primary contact name BERNARD SALLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DEBRA HUGHES
DIRECTOR
2215 BRISTOL BEND
KATY TX 77450

Officer/Director/Trustee Two

DONETTA DUNN
DIRECTOR
15512 WELDON DRIVE
HOUSTON TX 77032

Officer/Director/Trustee Three

KEVIN TIRCUIT
TREASURER
6002 BELMARK
HOUSTON TX 77033

Officer/Director/Trustee Four

BERNARD SALLEY
PRESIDENT
12618 MIRIAM LANE
HOUSTON TX 77071

Officer/Director/Trustee Five

DELPHINE SALLEY
CHAIRPERSON
12618 MIRIAM LANE
HOUSTON TX 77071

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/2015
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G84 - Autism
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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