FORM 1023-EZ for A STROKE SURVIVAL EXPERIENCE
| Field | Data |
|---|---|
| EIN | 82-3262241 |
| Case Number | EO-2021158-000243 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | A STROKE SURVIVAL EXPERIENCE |
| Organization’s Mailing Address | 5334 MERRIMAC AVENUE |
| City | DALLAS |
| State | TX |
| ZIP | 75206 |
| Accounting period End | 12 |
| Primary contact name | DEREK MILLER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JONATHAN MILLER
PRESIDENT
5334 MERRIMAC AVENUE
DALLAS TX 75206
Officer/Director/Trustee Two
AMY DANIELS
BOARD MEMBER
5334 MERRIMAC AVENUE
DALLAS TX 75206
Officer/Director/Trustee Three
JENNIFER CARFLEY
BOARD MEMBER
14 MOLASES HILL ROAD
LEBANON NJ 08833
Officer/Director/Trustee Four
JOSHUA BANTZ
BOARD MEMBER
2844 MICHENER DRIVE
LANCASTER PA 17601
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/23/2018 |
| Organization Incorporation State | TX |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E86 - Patient Services - Entertainment, Recreation |
| 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 | 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 | JONATHAN MILLER |
| Signature Title | PRESIDENT |
| Signature Date | 6/3/2021 |
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