FORM 1023-EZ for DRIVEN YOUTH SERVICES INC

Field Data
EIN 84-2925229
Case Number EO-2019319-000076
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DRIVEN YOUTH SERVICES INC
Organization’s Mailing Address 1776 BOSTON ROAD 3C
City BRONX
State NY
ZIP 10460-4907
Accounting period End 12
Primary contact name SANDY MCINNIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOELENE JOHNSON
EXECUTIVE DIRECTOR
1776 BOSTON ROAD 3C
BRONX NY 10460-4907

Officer/Director/Trustee Two

PATRICIA JONES
PRESIDENT COO
165 ST ANN AVENUE 1B
BRONX NY 10454-4715

Officer/Director/Trustee Three

JON GABAY
VICE PRESIDENT
535 WEST 150TH STREET 31
NEW YORK NY 10031-2604

Officer/Director/Trustee Four

JOE BLACK
TREASURER
780 CONCOURSE VILLAGE WEST 16L
BRONX NY 10451-3805

Officer/Director/Trustee Five

TRACEY HINES
ADMINISTRATIVE OFFICER
774 ROCKAWAY AVENUE 6K
BROOKLYN NY 11212-5839

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/18
Organization Incorporation State NY
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: 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 JOELENE JOHNSON
Signature Title EXECUTIVE DIRECTOR
Signature Date 11/13/19

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