FORM 1023-EZ for YOUTHSAFE

Field Data
EIN 84-3794619
Case Number EO-2020085-000116
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name YOUTHSAFE
Organization’s Mailing Address 717 PERCY ST
City GREENSBORO
State NC
ZIP 27405
Accounting period End 6
Primary contact name JONATHAN HEIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JONATHAN HEIN
DIRECTOR
717 PERCY ST
GREENSBORO NC 27405

Officer/Director/Trustee Two

JOSHUA MATA
BOARD MEMBER
1105 LATHAM RD
GREENSBORO NC 27408

Officer/Director/Trustee Three

CARRIE HART
BOARD MEMBER
2741 LULLINGTON DR
GREENSBORO NC 27103

Organization’s website YOUTHSAFEGSO.ORG
Organization’s email YOUTHSAFEGSO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/15/2019
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 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 JONATHAN HEIN
Signature Title DIRECTOR
Signature Date 3/23/2020

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