FORM 1023-EZ for YOUR PAST DOES NOT DEFINE YOU

Field Data
EIN 87-0823615
Case Number EO-2021172-000457
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name YOUR PAST DOES NOT DEFINE YOU
Organization’s Mailing Address 1432 14TH STREET
City PLEASANT GROVE
State AL
ZIP 35127
Accounting period End 12
Primary contact name ADRIENNE PERRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ADRIENNE PERRY
CEO
1432 14TH STREET
PLEASANT GROVE AL 35127

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2021
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical Services
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
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 ADRIENNE PERRY
Signature Title CEO
Signature Date 6/17/2021

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