FORM 1023-EZ for PHOENIX RESIDENTIAL REENTRY AND COMMUNITY REINTEGRATION

Field Data
EIN 81-2228039
Case Number EO-2016116-000466
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PHOENIX RESIDENTIAL REENTRY AND COMMUNITY REINTEGRATION
Organization’s Mailing Address 5208 S 12TH WAY
City PHOENIX
State AZ
ZIP 85040
Accounting period End 12
Primary contact name SEBASTIAN RANDOLPH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SEBASTIAN RANDOLPH JR
DIR OF OPERATIONS
1330 W BASELINE STE 243
TEMPE AZ 85283

Officer/Director/Trustee Two

RYAN RANDOLPH
DIR OF HUMAN RESOURCES
1330 W BASELINE STE 243
TEMPE AZ 85283

Officer/Director/Trustee Three

PORCHE SMITH
DIR OF NEW SOIL FOUNDATION
1942 W 22ND STREET SUITE 3
LOS ANGELES CA 90018

Officer/Director/Trustee Four

STEPHANIE KNOX
DIR OF SUPPORTIVE HOUSING
POST OFFICE BOX 30302
PHOENIX AZ 85046

Officer/Director/Trustee Five

BRENDA SANTOS
DIRECTOR OF FINANCE
2274 E SAHUARO DRIVE
PHOENIX AZ 85028

Organization’s website
Organization’s email PHOENIXRESIDENTIALREENTRY@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/6/2016
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- 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 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 Yes
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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