FORM 1023-EZ for BEAUTIFULLY BROKEN INC

Field Data
EIN 85-2687682
Case Number EO-2020295-000408
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BEAUTIFULLY BROKEN INC
Organization’s Mailing Address 2938 FAIR CHASE DRIVE
City KATY
State TX
ZIP 77494
Accounting period End 12
Primary contact name ALEXANDRIA FALLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALEXANDRIA FALLS
CEO/PRESIDENT
2938 FAIR CHASE DRIVE
KATY TX 77494

Officer/Director/Trustee Two

VALENCIA SUTHERLAND
DIRECTOR/TREASURER
2938 FAIR CHASE DRIVE
KATY TX 77494

Officer/Director/Trustee Three

DORIAN FALLS
DIRECTOR/SECRETARY
2938 FAIR CHASE DRIVE
KATY TX 77494

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/19/2020
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P43 - Family Violence Shelters, 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 No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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 ALEXANDRIA FALLS
Signature Title CEO/PRESIDENT
Signature Date 10/13/2020

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