FORM 1023-EZ for PRISON DID NOT BREAK ME

Field Data
EIN 86-2593449
Case Number EO-2021097-000576
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PRISON DID NOT BREAK ME
Organization’s Mailing Address 6412 TIGER RD
City PIERCE CITY
State MO
ZIP 65723
Accounting period End 12
Primary contact name SHEENA EASTBURN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHEENA EASTBURN
DIRECTOR
6412 TIGER RD
PIERCE CITY MO 65723

Officer/Director/Trustee Two

CHARLA PATTERSON
VICE PRESIDENT
519 EASTGATE
MIAMI OK 74354

Officer/Director/Trustee Three

TYLER RODGERS
SARGENT AT ARMS
6412 TIGER RD
PIERCE CITY MO 65723

Officer/Director/Trustee Four

CHRIS MCCURLEY
TREASURER
1817 FAIRCHILD ST
CHILLICOTHE MO 64601

Officer/Director/Trustee Five

STEPHANIE MOORE
SECRETARY
8892 MAYA LANE APT 1
JENNINGS MO 63136

Organization’s website WWW.PRISONDIDNOTBREAKME.ORG
Organization’s email PRISONDIDNOTBREAKME@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/2021
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I40 - Rehabilitation Services for Offenders
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 Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SHEENA EASTBURN
Signature Title DIRECTOR
Signature Date 3/13/2021

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