FORM 1023-EZ for WILK-AMITE YOUTH ACTION NETWORK

Field Data
EIN 81-1608630
Case Number EO-2016077-000039
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WILK-AMITE YOUTH ACTION NETWORK
Organization’s Mailing Address 1012 WEST CHEROKEE STREET
City CENTREVILLE
State MS
ZIP 39631
Accounting period End 12
Primary contact name DAVID WALKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVID WALKER
PRESIDENT
1012 WEST CHEROKEE STREET
CENTREVILLE MS 39631

Officer/Director/Trustee Two

DONALD JACKSON JR
TREASURER
54 JACKSON LANE
CENTREVILLE MS 39631

Officer/Director/Trustee Three

BARRY COLLINS
SECRETARY
3354 PEPPERHOUSE ROAD
GLOSTER MS 39638

Organization’s website
Organization’s email HEALTHY39631@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/2016
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development 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
Signature Title
Signature Date

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