FORM 1023-EZ for SAMARITANS MISSION ORGANIZATION

Field Data
EIN 81-5307077
Case Number EO-2020269-000444
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAMARITANS MISSION ORGANIZATION
Organization’s Mailing Address 4700 WILLOW COVE BLVD APT C4
City ALLEN PARK
State MI
ZIP 48101
Accounting period End 12
Primary contact name CRYSTAL THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CRYSTAL THOMAS
CEO/DIRECTOR
4700 WILLOW COVE BLVD C4
ALLEN PARK MI 48101

Officer/Director/Trustee Two

DANIELLE FIELDER
PRESIDENT
4617 WILLOW COVE G14
ALLEN PARK MI 48101

Officer/Director/Trustee Three

LAKEYSHA KNOWLES
SECRETARY
8244 WEST PARKWAY
REDFORD MI 48239

Officer/Director/Trustee Four

RONALD DAVIE
TREASURER
8332 BRYDEN
DETROIT MI 48204

Organization’s website
Organization’s email SAMARITANSONAMISSION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/2017
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 CRYSTAL THOMAS
Signature Title DIRECTOR
Signature Date 9/23/2020

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