FORM 1023-EZ for THE SAMARITAN MISSION INC

Field Data
EIN 46-2615684
Case Number EO-2016295-000085
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE SAMARITAN MISSION INC
Organization’s Mailing Address 6315 VINE ST REAR 3
City CINCINNATI
State OH
ZIP 45216
Accounting period End 12
Primary contact name ERIN EDEBOHLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOROTHY WILSON
PRESIDENT
6315 VINE STREET
CINCINNATI OH 45216

Officer/Director/Trustee Two

JAMES WILSON JR
VICE PRESIDENT
964 WOODMILL LANE
CINCINNATI OH 45231

Officer/Director/Trustee Three

KAMILLA JACKSON
SECRETARY
823 YORKHAVEN ROAD
CINCINNATI OH 45240

Officer/Director/Trustee Four

ARLETTA WILSON
TREASURER
330 WASHINGTON AVENUE
CINCINNATI OH 45215

Officer/Director/Trustee Five

NICOLE HOLT
DIRECTOR
12176 DEERHORN DRIVE
CINCINNATI OH 45240

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/12/2013
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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