FORM 1023-EZ for T1DIABETES JOURNEY INC

Field Data
EIN 82-2404665
Case Number EO-2017244-000060
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name T1DIABETES JOURNEY INC
Organization’s Mailing Address PO BOX 12442
City CINCINNATI
State OH
ZIP 45215
Accounting period End 6
Primary contact name ANTROINETTE WORSHAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTROINETTE WORSHAM
BOARD OF DIRECTOR/TREASURER
5370 LEES CROSSING DRIVE
CINCINNATI OH 45239

Officer/Director/Trustee Two

DEASA CAIN
BOARD MEMBER
6828 BETTS AVE
CINCINNATI OH 45239

Officer/Director/Trustee Three

CHAUNICE COLLINS
BOARD SECRETARY
2090 MISTYHILL DRIVE
CINCINNATI OH 45240

Officer/Director/Trustee Four

KIMBERLY THOMAS
VICE PRESIDENT
8001 BOBOLINK DRIVE
CINCINNATI OH 45224

Officer/Director/Trustee Five

ARMAINE BROWN
PRESIDENT
5370 LEES CROSSING DRIVE
CINCINNATI OH 45239

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/2017
Organization Incorporation State OH
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: 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 Yes
Benefit of College No
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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