FORM 1023-EZ for FRESH START OUTREACH SERVICE

Field Data
EIN 82-3490221
Case Number EO-2017328-000456
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FRESH START OUTREACH SERVICE
Organization’s Mailing Address P O BOX 792
City YORKTOWN
State VA
ZIP 23692
Accounting period End 12
Primary contact name RENEE E STURDIVANT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RENEE STURDIVANT
DIRECTOR
P O BOX 792
YORKTOWN VA 23692

Officer/Director/Trustee Two

JANICE HOUFF
DIRECTOR
P O BOX 234
SEAFORD VA 23696

Officer/Director/Trustee Three

SIMONE JACKSON
DIRECTOR
137 LESTER ROAD
PARK FOREST IL 60466

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/22/2017
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P50 - Personal Social 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 No
Donation of funds No
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 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
Signature Title
Signature Date

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