FORM 1023-EZ for ADASSA CHRISTIAN LEADERSHIP CORPORATION

Field Data
EIN 82-4170665
Case Number EO-2018038-000307
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ADASSA CHRISTIAN LEADERSHIP CORPORATION
Organization’s Mailing Address 178 MAIN AVENUE
City WHEATLEY HEIGHTS
State NY
ZIP 11798-1000
Accounting period End 12
Primary contact name SAMOYA HENRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMOYA HENRY
EXECUTIVE DIRECTOR/PRESIDENT
178 MAIN AVENUE
WHEATLEY HEIGHTS NY 11798-1000

Officer/Director/Trustee Two

BARBARA ROSE
TREASURER
178 MAIN AVENUE
WHEATLEY HEIGHTS NY 11798-1000

Officer/Director/Trustee Three

ODELLEY HENRY
VICE PRESIDENT
126 N 24STREET
WYANDANCH NY 11798-1000

Officer/Director/Trustee Four

RAYMOND ROSE
BOARD MEMBER
562 BROADHALLOW RD
MELVILLE NY 11747

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/18
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development 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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
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 SAMOYA HENRY
Signature Title EXECUTIVE DIRECTOR/PRESIDENT
Signature Date 2/5/18

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