FORM 1023-EZ for SANTANA OUTREACH INC

Field Data
EIN 84-4278791
Case Number EO-2020027-000540
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SANTANA OUTREACH INC
Organization’s Mailing Address 236 PATTERNOTE RD
City MOORESVILLE
State NC
ZIP 28117
Accounting period End 12
Primary contact name WILLIE TOLBERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDWARD T JACKSON
PRESIDENT
236 PATTERNOTE RD
MOORESVILLE NC 28117

Officer/Director/Trustee Two

ANNIE JACKSON
TRUSTEE
805 CAMERON VILLAGE DRIVE
CHARLOTTE NC 28105

Officer/Director/Trustee Three

JANE AURELIO
TRUSTEE
236 PATTERNOTE RD
MOORESVILLE NC 28117

Officer/Director/Trustee Four

LEONAR COLCLOUGH
TRUSTEE
8400 REGO STREET
CHARLOTTE NC 28216

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/8/2019
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 EDWARD T JACKSON
Signature Title PRESIDENT
Signature Date 1/24/2020

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