FORM 1023-EZ for HIS WORKS OUTREACH MINISTRY AND FOODBANK INCORPORATED

Field Data
EIN 82-4337562
Case Number EO-2018141-000550
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HIS WORKS OUTREACH MINISTRY AND FOODBANK INCORPORATED
Organization’s Mailing Address 228 EMANNUEL DRIVE
City LYONS
State GA
ZIP 30436
Accounting period End 12
Primary contact name SANTINA FRYER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGEL JACKSON
PRESIDENT
228 EMMANUEL DRIVE
LYONS GA 30436

Officer/Director/Trustee Two

MARI MARTINEZ
VICE PRESIDENT
103 WIGGINS CIRCLE
VIDALIA GA 30434

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/6/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 ANGEL JACKSON
Signature Title PRESIDENT
Signature Date 5/18/18

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