FORM 1023-EZ for SHATTERED PIECES MINISTRIES INC

Field Data
EIN 87-0861805
Case Number EO-2021189-000229
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHATTERED PIECES MINISTRIES INC
Organization’s Mailing Address 220 E UNIVERSITY BLVD UNIT 1202
City MELBOURNE
State FL
ZIP 32901
Accounting period End 12
Primary contact name LATASHA JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LATASHA JOHNSON
PRESIDENT
220 E UNIVERSITY BLVD UNIT 1202
MELBOURNE FL 32901

Officer/Director/Trustee Two

KATINA LOCKHART
VICE PRESIDENT
466 FOXDALL AVE NE
PALM BAY FL 32907-2531

Officer/Director/Trustee Three

YAMESI STEWARD
ADMINISTRATOR-COOK
2903 LEONARD WEAVER BLVD
MELBOURNE FL 32901

Officer/Director/Trustee Four

TIFFANY INGRIM
ADMINISTRATOR-EVENT PLAN
220 E UNIVERSITY BLVD UNIT 1305
MELBOURNE FL 32901

Organization’s website
Organization’s email MS.JOHNSON2321@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/25/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B60 - Adult, Continuing Education
Organization’s purpose Charitable: No
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 Yes
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 Yes
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 LATASHA JOHNSON
Signature Title PRESIDENT
Signature Date 7/6/2021

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