FORM 1023-EZ for THE SHAVERS-COBB FOUNDATION

Field Data
EIN 82-4302459
Case Number EO-2018040-000265
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE SHAVERS-COBB FOUNDATION
Organization’s Mailing Address 2307 FOREST KNOLL DRIVE
City PINE BLUFF
State AR
ZIP 71603
Accounting period End 5
Primary contact name DONOVAN SHAVERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONOVAN SHAVERS
EXECUTIVE DIRECTOR
2307 FOREST KNOLL DRIVE
PINE BLUFF AR 71603

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/17
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 DONOVAN SHAVERS
Signature Title EXECUTIVE DIRECOTOR
Signature Date 2/7/18

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