FORM 1023-EZ for CIVILIANS AGAINST VIOLENCE TNBPN CLEVE CH

Field Data
EIN 86-1815811
Case Number EO-2021092-000056
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CIVILIANS AGAINST VIOLENCE TNBPN CLEVE CH
Organization’s Mailing Address 17325 EUCLID AVENUE SUITE 4076
City CLEVELAND
State OH
ZIP 44112
Accounting period End 12
Primary contact name ANDRE DODSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDRE DODSON
EXECUTIVE DIRECTOR
34466 CEDAR TRAIL UNIT 4
WILLOUGHBY OH 44094-7343

Officer/Director/Trustee Two

KATRICIA DODSON
DIRECTOR/VICE PRESIDENT
34466 CEDAR TRAIL UNIT 4
WILLOUGHBY OH 44094-7343

Officer/Director/Trustee Three

DELPHINIA SQUIRE
DIRECTOR/TREASURER
27600 CHARDON ROAD SUITE 557
WILLOUGHBY HILLS OH 44092-2902

Officer/Director/Trustee Four

TIERRA BANKS
DIRECTOR/SECRETARY
1830 CLOVER AVENUE
CLEVELAND OH 44094-7343

Officer/Director/Trustee Five

ANGELA DOUGLAS
DIRECTOR
1221 E 111TH ST
CLEVELAND OH 44108-3730

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/2021
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I21 - Delinquency Prevention
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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 ANDRE DODSON
Signature Title EXECUTIVE DIRECTOR
Signature Date 2/23/2021

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