FORM 1023-EZ for UMBRELLA IMPACT

Field Data
EIN 85-2798423
Case Number EO-2021093-000170
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name UMBRELLA IMPACT
Organization’s Mailing Address 25 WEST PROSPECT STREET
City WEST HAVEN
State CT
ZIP 06516
Accounting period End 12
Primary contact name NASIYRA CLAYTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EMMETT MCCARTHY
BOD MEMBER
14 MARLEN DRIVE
NORTH HAVEN CT 06473

Officer/Director/Trustee Two

DEBORAH BOYD
BOD MEMBER
776 WEST MIN STREET
WEST HAVEN CT 06516

Officer/Director/Trustee Three

IVA JOHNSON
BOD MAMBER
113 ROCK CREEK ROAD
NEW HAVEN CT 06515

Officer/Director/Trustee Four

BRENDA EDWARDS
BOD MEMBER
428 ORCHARD STREET
NEW HAVEN CT 06511

Officer/Director/Trustee Five

NASIYRA CLAYTON
DIRECTOR
25 WEST PROSPECT STREET
WEST HAVEN CT 06515

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/30/2020
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 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 NASIYRA CLAYTON
Signature Title DIRECTOR
Signature Date 2/26/2021

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