FORM 1023-EZ for SHIRLEY K MALLETT FOUNDATION

Field Data
EIN 45-3009170
Case Number EO-2020143-000177
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHIRLEY K MALLETT FOUNDATION
Organization’s Mailing Address 19626 SUMMERLIN DR
City KATY
State TX
ZIP 77449
Accounting period End 12
Primary contact name JAY JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS BAKER
PRESIDENT
3616 RICHMOND AVE
HOUSTON TX 77046

Officer/Director/Trustee Two

TONYA BIAS
VICE PRESIDENT
6503 BAYOU VIEW DR
HOUSTON TX 77091

Officer/Director/Trustee Three

JAY JACKSON
CHIEF EXECUTIVE DIRECTOR
19626 SUMMERLIN DR
KATY TX 77449

Officer/Director/Trustee Four

JESSE TAYLOR
SECRETARY
802 LAURA ST
QUINCY FL 32351

Officer/Director/Trustee Five

HARVEY SMITH
TREASURER
9254 SOLVISTA PASS LN
HOUSTON TX 77070

Organization’s website SKMALLETT.ORG
Organization’s email INFO.SKMALLETT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/19/2011
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
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 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 JAY JACKSON
Signature Title CHIEF EXECUTIVE DIRECTOR
Signature Date 5/19/2020

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