FORM 1023-EZ for TEEN-OSITY

Field Data
EIN 82-2478134
Case Number EO-2020140-000139
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEEN-OSITY
Organization’s Mailing Address 101 CEDAR BROOK DRIVE
City PEARL
State MS
ZIP 39208
Accounting period End 7
Primary contact name SHANTA MCNAIR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ADRIANNA HOOKER
PRESIDENT
101 MOUNT SALUS ROAD B3
CLINTON MS 39056

Officer/Director/Trustee Two

ALNISHA MAYES
SECRETARY
5425 CLINTON BLVD APT SJ2
JACKSON MS 39209

Officer/Director/Trustee Three

DARIUS MCNAIR
VICE PRESIDENT
101 CEDAR BROOK
JACKSON MS 39208

Officer/Director/Trustee Four

KELLI WILLIAMS
TREASURER
3555 JACKYE LANE
JACKSON MS 39213

Officer/Director/Trustee Five

SHANTA MCNAIR
EXECUTIVE DIRECTOR
101 CEDAR BROOK DRIVE
PEARL MS 39208

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/2017
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P73 - Group Home (Long Term)
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 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 SHANTA MCNAIR
Signature Title EXECUTIVE DIRECTOR
Signature Date 5/17/2020

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