FORM 1023-EZ for JEFFERSON COUNTY YOUNG BOYZ TO MENMENTORING PROGRAM INC

Field Data
EIN 47-4962884
Case Number EO-2019112-000783
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JEFFERSON COUNTY YOUNG BOYZ TO MENMENTORING PROGRAM INC
Organization’s Mailing Address 3566 S JEFFERSON STREET
City MONTICELLO
State FL
ZIP 32344
Accounting period End 12
Primary contact name BARRY G GRAHAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID WILLIAMS JR
PRESIDENT
3566 S JEFFERSON STREET
MONTICELLO FL 32344

Officer/Director/Trustee Two

BARRY G GRAHAM
VICE PRESIDENT
1534 PINEY WOODS ROAD
MONTICELLO FL 32344

Officer/Director/Trustee Three

SHANKA FARMER
SECRETARY
511 WAUKEENAH HWY
MONTICELLO FL 32344

Officer/Director/Trustee Four

WILLIAM HICKS
TREASURER
1322 COOK RD
LAMONT FL 32336

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/16/15
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
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 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 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 BARRY G GRAHAM
Signature Title VICE PRESIDENT
Signature Date 4/20/19

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