FORM 1023-EZ for MIRACLE ON LONG STREET

Field Data
EIN 81-3114799
Case Number EO-2016187-000104
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MIRACLE ON LONG STREET
Organization’s Mailing Address 1786 EAST LONG STREET
City COLUMBUS
State OH
ZIP 43203
Accounting period End 12
Primary contact name HELEN ROOTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HELEN ROOTS
CEO AND TRUSTEE/DIRECTOR
1786 EAST LONG STREET
COLUMBUS OH 43203

Officer/Director/Trustee Two

SEVELLA LEWIS
TRUSTEEDIRECTOR-SECRETARY
1472 WILMORE DRIVE
COLUMBUS OH 43229

Officer/Director/Trustee Three

JEFFREY SHERMAN
TRUSTEE-DIRECTOR-TREASURER
165 DESANTIS DRIVE
COLUMBUS OH 43214

Organization’s website
Organization’s email JRPLAYERS@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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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