FORM 1023-EZ for DJS4 CHARITY FOUNDATION

Field Data
EIN 80-0778777
Case Number EO-2016210-000139
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DJS4 CHARITY FOUNDATION
Organization’s Mailing Address 4108 SW GREEN OAKS BLVD
City ARLINGTON
State TX
ZIP 76003
Accounting period End 12
Primary contact name BRUCE MONTGOMERY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRUCE MONTGOMERY
DIRECTOR
1055 REGAL ROW STE 1007
DALLAS TX 75247

Officer/Director/Trustee Two

BRUCE WHITE
DIRECTOR
P O BOX 87305
MESQUITE TX 75150

Officer/Director/Trustee Three

CANDACE WILLIAMS
DIRECTOR
PO BOX 170607
ARLINGTON TX 76003

Officer/Director/Trustee Four

RANDY BARRETT
DIRECTOR
4401 LITTLE RD ST
ARLINGTON TX 76016

Organization’s website NA
Organization’s email INFO@DJS4CHARITY.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/2011
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - Fund Raising and/or Fund Distribution
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 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
Signature Title
Signature Date

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