FORM 1023-EZ for THE PATCHWORK SOCIETY

Field Data
EIN 84-1806685
Case Number EO-2019316-000040
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE PATCHWORK SOCIETY
Organization’s Mailing Address 717 SANDY TRL
City FORT WORTH
State TX
ZIP 76120
Accounting period End 12
Primary contact name FELISHA BURLESON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FELISHA BURLESON
EXECUTIVE DIRECTOR
717 SANDY TRL
FORT WORTH TX 76120

Officer/Director/Trustee Two

TREENA MCROY
YOUTH PROGRAMS DIRECTOR
5904 SHADY SPRINGS TRL
FORT WORTH TX 76179

Officer/Director/Trustee Three

CYNTHIA GRADY
BUSINESS DIRECTOR
8632 PAPER BIRCH LN
FORT WORTH TX 76123

Officer/Director/Trustee Four

BRITTANY WILLIAMS
OUTREACH DIRECTOR
13030 AUDELIA RD 1173
DALLAS TX 75243

Officer/Director/Trustee Five

TAMARA BENTON
SECREATARY
1624 SCHUMAC LN
BEDFORD TX 76052

Organization’s website PATCHWORKSOCIETY.ORG
Organization’s email INFO@PATCHWORKSOCIETY.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/4/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 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 Yes
Correctness Declaration Yes
Signature Name FELISHA BURLESON
Signature Title EXECUTIVE DIRECTOR
Signature Date 11/7/19

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