FORM 1023-EZ for 3 RAW FORKS INC

Field Data
EIN 84-5087076
Case Number EO-2020073-000397
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 3 RAW FORKS INC
Organization’s Mailing Address 1540 W 14TH ST
City RIVIERA BEACH
State FL
ZIP 33404
Accounting period End 12
Primary contact name SHANDR STRINGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DERRICK WELLS
PRESIDENT AND CEO
1540 WEST 14TH ST
RIVIERA BEACH FL 33404

Officer/Director/Trustee Two

ERIKA DANIELS
DIRECTOR
1540 W 14TH ST
RIVIERA BEACH FL 33404

Officer/Director/Trustee Three

DERRICK WELLS JR
DIRECTOR
1540 W 14TH ST
RIVIERA BEACH FL 33404

Officer/Director/Trustee Four

MICKEY MURDOCK
DIRECTOR
1540 W 14TH ST
RIVIERA BEACH FL 33404

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/18/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
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 DERRICK WELLS
Signature Title PRESIDENT AND CEO
Signature Date 3/11/2020

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