FORM 1023-EZ for SAMARITANS OF PLAINVIEW

Field Data
EIN 84-2133857
Case Number EO-2019176-000375
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAMARITANS OF PLAINVIEW
Organization’s Mailing Address 2913 KERMIT ST
City PLAINVIEW
State TX
ZIP 79072
Accounting period End 12
Primary contact name DAVID JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID JOHNSON
PRESIDENT, DIRECTOR
2913 KERMIT ST
PLAINVIEW TX 79072

Officer/Director/Trustee Two

SHELBY SHURBET
SECRETARY, DIRECTOR
2913 KERMIT ST
PLAINVIEW TX 79072

Officer/Director/Trustee Three

MINDY MORRISON
TREASURER, DIRECTOR
2913 KERMIT ST
PLAINVIEW TX 79072

Officer/Director/Trustee Four

RANDY WARWICK
DIRECTOR
2913 KERMIT ST
PLAINVIEW TX 79072

Officer/Director/Trustee Five

SHANNON THRASHER
DIRECTOR
2913 KERMIT ST
PLAINVIEW TX 79072

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/29/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID JOHNSON
Signature Title PRESIDENT, DIRECTOR
Signature Date 6/21/19

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