FORM 1023-EZ for UNIVERSAL GRAND LODGE OF TEXAS A FA M

Field Data
EIN 81-1215568
Case Number EO-2016111-000135
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UNIVERSAL GRAND LODGE OF TEXAS A FA M
Organization’s Mailing Address 6115 BACHER ST
City HOUSTON
State TX
ZIP 77028
Accounting period End 12
Primary contact name DERRICK EDWARDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DERRICK EDWARDS
PRESIDENT
1032 S FORK DR
LITTLE ELM TX 75068

Officer/Director/Trustee Two

LASHINA FOREMAN
DIRECTOR
8918 SARATOGA FOREST DR
HOUSTON TX 77088

Officer/Director/Trustee Three

DARREN HOGUES
DIRECTOR
7606 SMILINGWOOD LN
HOUSTON TX 77086

Organization’s website
Organization’s email MASONICTIGER23@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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
Signature Title
Signature Date

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