FORM 1023-EZ for THE OPEN PALMS INITIATIVE

Field Data
EIN 82-1960990
Case Number EO-2018026-000207
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE OPEN PALMS INITIATIVE
Organization’s Mailing Address 1212 QUEEN PEGGY LANE
City LEWISVILLE
State TX
ZIP 75056
Accounting period End 12
Primary contact name JORDAN BROCK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JORDAN BROCK
PRESIDENT/DIRECTOR
1212 QUEEN PEGGY LANE
LEWISVILLE TX 75056

Officer/Director/Trustee Two

CATHY MCCAIN
TREASURER/DIRECTOR
1212 QUEEN PEGGY LANE
LEWISVILLE TX 75056

Officer/Director/Trustee Three

AMY BLANKSON
SECRETARY/DIRECTOR
1212 QUEEN PEGGY LANE
LEWISVILLE TX 75056

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/20/17
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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 AMY BLANKSON
Signature Title SECRETARY/DIRECTOR
Signature Date 1/24/18

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