FORM 1023-EZ for KESI INC

Field Data
EIN 81-4316858
Case Number EO-2017017-000656
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KESI INC
Organization’s Mailing Address 13066 HUNTER BROOK DRIVE
City LAKE RIDGE
State VA
ZIP 22192-2469
Accounting period End 12
Primary contact name JACKIE DOZIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACKIE DOZIER
PRESIDENT
13066 HUNTER BROOK DRIVE
LAKE RIDGE VA 22192-2469

Officer/Director/Trustee Two

JAMES TUBAH
VICE PRESIDENT
13066 HUNTER BROOK DRIVE
LAKE RIDGE VA 22192-2469

Officer/Director/Trustee Three

MICHAEL EVAN JOHNSON
SECRETARY/TREASURER
13066 HUNTER BROOK DRIVE
LAKE RIDGE VA 22192-2469

Officer/Director/Trustee Four

DAVID GOLDSMITH
DIRECTOR
13066 HUNTER BROOK DRIVE
LAKE RIDGE VA 22192-2469

Officer/Director/Trustee Five

LARRY WILLIAMS
DIRECTOR
13066 HUNTER BROOK DRIVE
LAKE RIDGE VA 22192-2469

Organization’s website WWW.KES2020INC.COM
Organization’s email JDOZIER5630@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/7/2016
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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