FORM 1023-EZ for POETIC OUTREACH SHARED HOUSING

Field Data
EIN 85-1201219
Case Number EO-2020163-000284
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name POETIC OUTREACH SHARED HOUSING
Organization’s Mailing Address 10524 WILD MEADOW WAY
City FORT WORTH
State TX
ZIP 76108
Accounting period End 12
Primary contact name MELLITA HAYES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEANETTE SALCIDO-HAYES
PRESIDENT
10524
FORT WORTH TX 76108

Officer/Director/Trustee Two

ISHA THOMAS
SECRETARY
4221 OLD DENTON ROAD APT 4205
CARROLLTON TX 75010

Officer/Director/Trustee Three

SONYA BROWN
TREASURER
2518 SHERRY ST
ARLINGTON TX 76014

Officer/Director/Trustee Four

MELLITA HAYES
BOARD MEMBER
10524 WILD MEADOW WAY
FORT WORTH TX 76108

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/22/2020
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
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 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 MELLITA HAYES
Signature Title BOARD MEMBER
Signature Date 6/9/2020

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