FORM 1023-EZ for INNER CITY YOUTH REFUGE

Field Data
EIN 83-4700991
Case Number EO-2020132-000491
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INNER CITY YOUTH REFUGE
Organization’s Mailing Address 4859 W SLAUSON AVENUE SUITE 617
City LOS ANGELES
State CA
ZIP 90056
Accounting period End 12
Primary contact name CARNELL JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARNELL JACKSON
EXECUTIVE DIRECTOR
4859 W SLAUSON STE 617
LOS ANGELES CA 90056

Officer/Director/Trustee Two

KAYLA WRIGHT
DIRECTOR
4859 W SLAUSON AVE STE 617
LOS ANGELES CA 90056

Officer/Director/Trustee Three

LESSIE JACKSON
TREASURER
4859 W SLAUSON AVENUE STE 617
LOS ANGELES CA 90056

Officer/Director/Trustee Four

REGINAL PAYNE
DIRECTOR
4859 W SLAUSON AVENUE
LOS ANGELES CA 90056

Officer/Director/Trustee Five

ROBERT JACKSON
DIRECTOR
4859 W SLAUSON AVENUE
LOS ANGELES CA 90056

Organization’s website N/A
Organization’s email INNERCITYYOUTHREFUGE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2019
Organization Incorporation State CA
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 CARNELL JACKSON
Signature Title EXECUTIVE DIRECTOR
Signature Date 5/8/2020

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