FORM 1023-EZ for EHSAA OF DC

Field Data
EIN 45-4780180
Case Number EO-2017059-000187
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EHSAA OF DC
Organization’s Mailing Address 900 BRENTWOOD ROAD NE PO BOX 91141
City WASHINGTON
State DC
ZIP 20090
Accounting period End 12
Primary contact name JAMES THOMAS PRESIDENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES THOMAS
PRESIDENT
900 BRENTWOOD ROAD NE PO BOX 91141
WASHINGTON DC 20090

Officer/Director/Trustee Two

DERRICK BROWN
VP
900 BRENTWOOD ROAD NE PO BOX 91141
WASHINGTON DC 20090

Officer/Director/Trustee Three

AVIS JORDAN
EXECUTIVE SECRETARY
900 BRENTWOOD ROAD NE PO BOX 91141
WASHINGTON DC 20090

Officer/Director/Trustee Four

SHIRLEY GILMORE
TREASURER
900 BRENTWOOD ROAD NE PO BOX 91141
WASHINGTON DC 20090

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2012
Organization Incorporation State DC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W11 - Single Organization Support
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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