FORM 1023-EZ for DIRECTLY AFFECTED

Field Data
EIN 84-5004954
Case Number EO-2020069-000270
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DIRECTLY AFFECTED
Organization’s Mailing Address 528 DRY RUN ROAD
City WEST PORTSMOUTH
State OH
ZIP 45663
Accounting period End 12
Primary contact name DOMINIQUE MYRICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOMINIQUE MYRICK
DIRECTOR/PRESIDENT
528 DRY RUN ROAD
PORTSMOUTH OH 45663

Officer/Director/Trustee Two

JOCYLEN COOPER
DIRECTOR/VICE PRESIDENT
PO BOX184
PORTSMOUTH OH 45662

Officer/Director/Trustee Three

LAURA SLUSHER
VICE PRESIDENT
PO BOX 184
PORTSMOUTH OH 45662

Officer/Director/Trustee Four

NANCY MOORE
SECRETARY
PO BOX 184
PORTSMOUTH OH 45662

Officer/Director/Trustee Five

MEGAN KENNARD
TREASURER
PO BOX 184
PORTSMOUTH OH 45662

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/11/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DOMINIQUE MYRICK
Signature Title DIRECTOR/PRESIDENT
Signature Date 3/5/2020

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