FORM 1023-EZ for CAMP JIGSAW INC

Field Data
EIN 46-5740207
Case Number EO-2017276-000116
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAMP JIGSAW INC
Organization’s Mailing Address 577 SOUTH LAKE DR
City STARKVILLE
State MS
ZIP 39759
Accounting period End 12
Primary contact name SANDY DEVLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SANDY DEVLIN
FOUNDER DIRECTOR
577 SOUTH LAKE DR
STARKVILLE MS 39759

Officer/Director/Trustee Two

MATTHEW COLLIER
CO CHAIR
209 HILLSIDE DR
STARKVILLE MS 39759

Officer/Director/Trustee Three

HUNTER ANDREWS
CO CHAIR
110 LYNN LANE
STARKVILLE MS 39759

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/16/2014
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date
EIN 46-5740207
Case Number EO-2014322-000151
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAMP JIGSAW
Organization’s Mailing Address 577 SOUTH LAKE ROAD
City STARKVILLE
State MS
ZIP 39759
Accounting period End 12
Primary contact name SANDY DEVLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SANDY DEVLIN
FOUNDER/DIRECTOR
577 SOUTH LAKE RD
STARKVILLE MS 39759

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/2014
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
One Third Support Gifts No
Benefit of College Yes
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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