FORM 1023-EZ for S E L F MINISTRIES INC

Field Data
EIN 68-0610459
Case Number EO-2016064-000089
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name S E L F MINISTRIES INC
Organization’s Mailing Address 5406 GOLF DR
City HOUSTON
State TX
ZIP 77091-5515
Accounting period End 12
Primary contact name MICHAEL BLACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL BLACK
DIRECTOR
5406 GOLF
HOUSTON TX 77091-5515

Officer/Director/Trustee Two

ADRIENNE COLE
DIRECTOR
1827 SOUTHMORE
HOUSTON TX 77004-5901

Officer/Director/Trustee Three

ATIYA SIMPLE
DIRECTOR
1014 LODGEHILL LANE
HOUSTON TX 77090-1222

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/2005
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
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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