FORM 1023-EZ for BROOKS HOUSE OF HOPE

Field Data
EIN 84-2118378
Case Number EO-2020147-000636
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BROOKS HOUSE OF HOPE
Organization’s Mailing Address 2669 KIRBY RD 1202
City ROBINSONVILLE
State MS
ZIP 38664
Accounting period End 12
Primary contact name LASHONDA BROOKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JIMMY BROOKS
MANAGING SECURITY PERSONNEL
2669 KIRBY RD 1202
ROBINSONVILLE MS 38664

Officer/Director/Trustee Two

YOLANDA KEMP
PROGRAM DIRECTOR
1253 FIVE OAKS DRIVE NORTH
SOUTHAVEN MS 38671

Officer/Director/Trustee Three

PAMELA HARRIS PRYOR
CHIEF FINANCE OFFICER
1133 CLOVER LEAF
ROBINSONVILLE MS 38664

Officer/Director/Trustee Four

DEBRA HARRIS
COMMUNITY EVENT SPECIALIST
1015 SYCAMORE STREET
TUNICA MS 38676

Officer/Director/Trustee Five

KEIOSHIA BLACKMUN
INTAKE COORDINATOR
15 VICTOR STREET
HAMPTON VA 23669

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/18/2020
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 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 JIMMY BROOKS
Signature Title MANAGING SECURITY PERSONNEL
Signature Date 5/23/2020

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