FORM 1023-EZ for ADJUSTABLE CROWNS

Field Data
EIN 82-3997736
Case Number EO-2018064-000037
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ADJUSTABLE CROWNS
Organization’s Mailing Address 2549 HARVEST MOON DRIVE
City FORT WORTH
State TX
ZIP 76123
Accounting period End 12
Primary contact name LAMESA HEROD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAMESA HEROD
DIRECTOR/FOUNDER
2549 HARVEST MOON DRIVE
FORT WORTH TX 76123

Officer/Director/Trustee Two

NY-JA HEROD
DIRECTOR
2549 HARVEST MOON DRIVE
FORT WORTH TX 76123

Officer/Director/Trustee Three

TIFFANY BROWN
DIRECTOR
905 BLOOMFIELD
GRAND PRAIRIE TX 75052

Officer/Director/Trustee Four

AUDREY BROOKINS
DIRECTOR
1055 ENFILAR LANE
ARLINGTON TX 76017

Organization’s website
Organization’s email ADJUSTABLECROWNS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/6/17
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 LAMESA HEROD
Signature Title DIRECTOR/FOUNDER
Signature Date 3/1/18

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