FORM 1023-EZ for SAMARITAN RESCUE MISSION

Field Data
EIN 61-1803582
Case Number EO-2017228-000361
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAMARITAN RESCUE MISSION
Organization’s Mailing Address 2490 VALLEYDALE ROAD
City BIRMINGHAM
State AL
ZIP 35244
Accounting period End 12
Primary contact name STEVIE BOYE JALLAH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVIE JALLAH
PRESIDENT/CEO
3112 STONECREST DRIVE
BIRMINGHAM AL 35242

Officer/Director/Trustee Two

LARRELL WILKINSON
DIRECTOR
169 HILLCREST DRIVE
MONTEVALLO AL 35115

Officer/Director/Trustee Three

WAYNE NEWSOM
DIRECTOR
5287 GREYSTONE WAY
BIRMINGHAM AL 35242

Officer/Director/Trustee Four

KANDACE BRIDGES
DIRECTOR
623 PARKSIDE CIRCLE
HELENA AL 35080

Organization’s website
Organization’s email SRMCHARITY1@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/25/2016
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O55 - Youth Development - Religious Leadership
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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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