FORM 1023-EZ for PRAYERS FOR JASE

Field Data
EIN 81-4018373
Case Number EO-2017179-000207
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PRAYERS FOR JASE
Organization’s Mailing Address 5859 HAYES MILL ROAD
City BASKERVILLE
State VA
ZIP 23915
Accounting period End 12
Primary contact name CANDICE SMILEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CANDICE SMILEY
PRESIDENT
5859 HAYES MILL RD
BASKERVILLE VA 23915

Officer/Director/Trustee Two

MICHAEL TANNER
TREASURER
PO BOX 567
LACROSSE VA 23950

Officer/Director/Trustee Three

JESSICA GORDON
SECRETARY
8163 HIGHWAY ONE
SOUTH HILL VA 23970

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/2016
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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