FORM 1023-EZ for I AM SOMEBODY RESTORATION OUTREACH

Field Data
EIN 25-1915900
Case Number EO-2019084-000401
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name I AM SOMEBODY RESTORATION OUTREACH
Organization’s Mailing Address 4156 LONGVIEW RD
City STARKVILLE
State MS
ZIP 39759
Accounting period End 12
Primary contact name SHAVELL RICE DIRECTOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEXTER PETERSON
PRESIDENT
203 1/2 NORTH LAFAYETTE ST
STARKVILLE MS 39759

Officer/Director/Trustee Two

JOSHUA RICE
TREASURER, DIRECTOR
1000 LOUISVILLE ST LOT 32
STARKVILLE MS 39759

Officer/Director/Trustee Three

SHAVELL RICE
DIRECTOR
4156 LONGVIEW RD
STARKVILLE MS 39759

Officer/Director/Trustee Four

JIMMY L RICE
DIRECTOR, VICE PRESIDENT
4156 LONGVIEW RD
STARKVILLE MS 39759

Officer/Director/Trustee Five

CHRISTOPHER TAYLOR
DIRECTOR
220 N LONG ST
STARKVILLE MS 39759

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/08
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S81 - Women's Service Clubs
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
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 Yes
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 SHAVELL RICE
Signature Title DIRECTOR
Signature Date 3/21/19

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