FORM 1023-EZ for CHRISTINE W JOHNSON MEMORIAL FOUNDATION

Field Data
EIN 85-2693776
Case Number EO-2020244-000407
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHRISTINE W JOHNSON MEMORIAL FOUNDATION
Organization’s Mailing Address 1027 7TH AVE
City GRACEVILLE
State FL
ZIP 32440
Accounting period End 12
Primary contact name GERRAN VANCE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY WADSWORTH-HILL
PRESIDENT
1027 7TH AVE
GRACEVILLE FL 32440

Officer/Director/Trustee Two

ERIKA PRINGLEY
VICE PRESIDENT
4197 MYLES ST
MARIANNA FL 32446

Officer/Director/Trustee Three

SHEILA JEFFERSON
MEMBER
5489 PELHAM COURT
GRACEVILLE FL 32440

Officer/Director/Trustee Four

CRUSHELL FREEMAN
MEMBER
4197 MYLES ST
MARIANNA FL 32446

Officer/Director/Trustee Five

JERRAI YOUNG
MEMBER
5111 GALLOWAY RD
GRACEVILLE FL 32440

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/25/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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 KIMBERLY WADSWORTH-HILL
Signature Title PRESIDENT
Signature Date 8/27/2020

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