FORM 1023-EZ for SELFLESS FOUNDATION INC
| Field | Data |
|---|---|
| EIN | 47-5442991 |
| Case Number | EO-2019240-000281 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SELFLESS FOUNDATION INC |
| Organization’s Mailing Address | 4007 LONGBOW COURT |
| City | JAMESTOWN |
| State | NC |
| ZIP | 27282-7711 |
| Accounting period End | 12 |
| Primary contact name | YOHMINA KASEY |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
YOHMINA KASEY
BOARD CHAIR
4007
JAMESTOWN NC 27282-7711
Officer/Director/Trustee Two
INGRA CLEMENTS
VICE CHAIR
3484 WEAL ROAD
CHATHAM VA 24531
Officer/Director/Trustee Three
TSCHARNER KASEY
SECRETARY
2404 GUYER STREET
HIGH POINT NC 27406
Officer/Director/Trustee Four
DANIEL LEWIS
CHIEF FINANCIAL OFFICER
4618 WOOD WAY DRIVE
KERNERSVILLE NC 27282
Officer/Director/Trustee Five
MICHAEL PENNISON
COMMITTEE CHAIR
124 HARPER STREET
WINSTON-SALEM NC 27104
| Organization’s website | WWW.SELFLESSUSA.ORG |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/5/15 |
| Organization Incorporation State | NC |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | S12 - Fund Raising and/or Fund Distribution |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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 | YOHMINA KASEY |
| Signature Title | BOARD CHAIR |
| Signature Date | 8/26/19 |
| EIN | 47-5442991 |
| Case Number | EO-2016069-000143 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | SELFLESS FOUNDATION INC |
| Organization’s Mailing Address | 4007 LONGBOW COURT |
| City | JAMESTOWN |
| State | NC |
| ZIP | 27282 |
| Accounting period End | 12 |
| Primary contact name | JACQUELINE STANLEY |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
YOHMINA KASEY
BOARD CHAIR
4007 LONGBOW COURT
JAMESTOWN NC 27282
Officer/Director/Trustee Two
INGRA CLEMENTS
VICE CHAIR
3484 WEAL ROAD
CHATHAM VA 24531
Officer/Director/Trustee Three
TSCHARNER KASEY
SECRETARY
2404 GUYER STREET
HIGH POINT NC 27406
Officer/Director/Trustee Four
DANIEL LEWIS
CHIEF FINANCIAL OFFICER
3115-A WALNUT CREEK DRIVE
WILSON NC 27893
Officer/Director/Trustee Five
MICHAEL PENNISON
COMMITTEE CHAIR
124 HARPER STREET
WINSTON SALEM NC 27104
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/5/2015 |
| Organization Incorporation State | NC |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | S12 - Fund Raising and/or Fund Distribution |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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 | |
| Signature Title | |
| Signature Date |
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