FORM 1023-EZ for GOT YOU COVERED

Field Data
EIN 83-2609948
Case Number EO-2019053-000039
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GOT YOU COVERED
Organization’s Mailing Address 16664 NEW DENNISON RD
City MARION
State IL
ZIP 62959
Accounting period End 11
Primary contact name MICHELLE PARKER-CLARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE PARKER-CLARK
PRESIDENT
16664 NEW DENNISON RD
MARION IL 62959

Officer/Director/Trustee Two

EVELYN FUQUA
VICE PRESIDENT
1403 NORTON ST
CARTERVILLE IL 62918

Officer/Director/Trustee Three

KHRISSY HOLLISTER
VICE PRESIDENT
438 NORTH DIVISION ST
CARTERVILLE IL 62918

Officer/Director/Trustee Four

BRITTANY FUQUA
SECRETARY
601 SOUTH AIKMAN
MARION IL 62959

Officer/Director/Trustee Five

ERINN PICKFORD
TREASURER
701 RACHAEL CT
CARTERVILLE IL 62918

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/20/18
Organization Incorporation State IL
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ERINN PICKFORD
Signature Title TREASURER
Signature Date 2/20/19

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