FORM 1023-EZ for BACK ROOM OF HOPE

Field Data
EIN 83-0811511
Case Number EO-2018171-000630
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BACK ROOM OF HOPE
Organization’s Mailing Address 19 EAST MAIN STREET
City SHELBY
State OH
ZIP 44875
Accounting period End 12
Primary contact name JULIE BRITTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JULIE BRITTON
PRESIDENT
19 EAST MAIN STREET
SHELBY OH 44875

Officer/Director/Trustee Two

JENNIFER ARMS
VICE PRESIDENT
14 EAST SMILEY AVE
SHELBY OH 44875

Officer/Director/Trustee Three

SARAH ONEY
SECRETARY
19 EAST SMILEY AVE
SHELBY OH 44875

Officer/Director/Trustee Four

LARRY AMATO
TREASURER
19 NORTH LONG ST
SHELBY OH 44875

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/18
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support 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 No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JULIE BRITTON
Signature Title PRESIDENT
Signature Date 6/18/18

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