FORM 1023-EZ for SPECIAL NEEDS ASSURED INC

Field Data
EIN 85-4289610
Case Number EO-2021033-000076
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SPECIAL NEEDS ASSURED INC
Organization’s Mailing Address 8717 WEST 110TH STREET SUITE 420
City OVERLAND PARK
State KS
ZIP 66210
Accounting period End 12
Primary contact name SAMANTHA L SHEPHERD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMANTHA SHEPHERD
OFFICER
8717 WEST 110TH STREET SUITE 420
OVERLAND PARK KS 66210

Officer/Director/Trustee Two

KRISTEN ARMSTRONG
DIRECTOR
1 NORTH MAIN SUITE 419
HUTCHINSON KS 67501

Officer/Director/Trustee Three

GRACE CARRUBBA
DIRECTOR
101 SHEARWATER CT E APPT 66
JERSEY CITY NJ 07305

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/15/2020
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G12 - Fund Raising and/or Fund Distribution
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 No
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 SAMANTHA SHEPHERD
Signature Title OFFICER
Signature Date 12/15/2020

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