FORM 1023-EZ for SISTA SURVIVOR
| Field | Data |
|---|---|
| EIN | 83-4025928 |
| Case Number | EO-2019112-000356 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SISTA SURVIVOR |
| Organization’s Mailing Address | 2565 SHINNECOCK COURT |
| City | MURFREESBORO |
| State | TN |
| ZIP | 37127 |
| Accounting period End | 12 |
| Primary contact name | TINA CLARK |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
TINA CLARK
FOUNDER
2565 SHINNECOCK COURT
MURFREESBORO TN 37127
Officer/Director/Trustee Two
ANGELICIA SIMMONS
BOARD MEMBER
5122 THORNTON KNOLL WAY
RALEIGH NC 27616
Officer/Director/Trustee Three
CRYSTAL GAITHER
SECRETARY
1866 MORGAN TRACE DR
WINSTON-SALEM NC 27127
Officer/Director/Trustee Four
CHERISE JOHNSON
TREASURER
4214 SAWMILL TRACE DRIVE
CHARLOTTE NC 28213
Officer/Director/Trustee Five
AVANTI BENSON
BOARD MEMBER
4948 RUTH ROAD
VIRGINIA BEACH VA 23464
| Organization’s website | |
|---|---|
| Organization’s email | SISTASURVIVOR2019@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/15/19 |
| Organization Incorporation State | TN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G30 - Cancer |
| 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 | 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 | 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 | TINA CLARK |
| Signature Title | FOUNDER |
| Signature Date | 4/17/19 |
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