FORM 1023-EZ for TELOS

Field Data
EIN 46-3429639
Case Number EO-2016278-000212
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TELOS
Organization’s Mailing Address 3714 RUFFIN ROAD
City NORTH PRINCE GEORGE
State VA
ZIP 23860-8629
Accounting period End 12
Primary contact name B
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN JACKSON
DIRECTOR
3714 RUFFIN ROAD
NORTH PRINCE GEORGE VA 23860-8629

Officer/Director/Trustee Two

YVETTE CARTER
CHAIRPERSON
3714 RUFFIN ROAD
NORTH PRINCE GEORGE VA 23860-8629

Officer/Director/Trustee Three

KEITH JACKSON
DIRECTOR
3714 RUFFIN ROAD
NORTH PRINCE GEORGE VA 23860-8629

Officer/Director/Trustee Four

OSCAR TAYLOR
DIRECTOR
3714 RUFFIN ROAD
NORTH PRINCE GEORGE VA 23860-8629

Officer/Director/Trustee Five

CRYSTAL KIMBLE
DIRECTOR
3714 RUFFIN ROAD
NORTH PRINCE GEORGE VA 23860-8629

Organization’s website NA
Organization’s email BKJACKSON@CONTROLLEDOUTCOMES.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/2013
Organization Incorporation State VA
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: 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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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