FORM 1023-EZ for BREAKOUT
| Field | Data |
|---|---|
| EIN | 86-1564175 |
| Case Number | EO-2021091-000769 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BREAKOUT |
| Organization’s Mailing Address | 1443 STUART ST |
| City | DENVER |
| State | CO |
| ZIP | 80204 |
| Accounting period End | 12 |
| Primary contact name | SADIE SMITH |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SADIE SMITH
DIRECTOR
1443 STUART ST
DENVEFR CO 80204-1244
Officer/Director/Trustee Two
TIM EBY-MCKENZIE
DIRECTOR
13426 RED HAWK DR
SYLMAR CA 91342-4495
Officer/Director/Trustee Three
KELLY SMYTH-DENT
DIRECTOR
1200 RIVERSIDE DR UNIT 1280
RENO NV 89503-5471
| Organization’s website | WWW.BREAKOUTHEALING.ORG |
|---|---|
| Organization’s email | BREAKOUTHEALING@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/3/2021 |
| Organization Incorporation State | CO |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F11 - Single Organization Support |
| 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 | Yes |
| 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 | SADIE SMITH |
| Signature Title | DIRECTOR |
| Signature Date | 2/21/2021 |
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