FORM 1023-EZ for GIVING BACK 941 INC

Field Data
EIN 85-2021108
Case Number EO-2020273-000082
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GIVING BACK 941 INC
Organization’s Mailing Address 13225 MJ RD
City MYAKKA
State FL
ZIP 34251
Accounting period End 12
Primary contact name JOAN KAUTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HOLLEY DEKMAR
PRESIDENT
13225 MJ RD
MYAKKA FL 34251

Officer/Director/Trustee Two

BARBARA GARDEN
DIRECTOR
13225 MJ RD
MYAKKA FL 34251

Officer/Director/Trustee Three

DAWN MITCHELL
DIRECTOR
13225 MJ RD
MYAKKA FL 34251

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 HOLLEY DEKMAR
Signature Title PRESIDENT
Signature Date 9/27/2020

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