FORM 1023-EZ for ACTIVE PLUS INC

Field Data
EIN 47-4146731
Case Number EO-2015189-000143
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ACTIVE PLUS INC
Organization’s Mailing Address C/O WEINBERG 90 STATE ST SUITE 815
City ALBANY
State NY
ZIP 12207
Accounting period End 12
Primary contact name JOAN GRAHAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TARIK KITSON
PRESIDENT
392 CENTRAL PARK WEST APT 8Y
NEW YORK NY 10025

Officer/Director/Trustee Two

MIGUEL ROXAS
DIRECTOR
317 E 90TH ST APT 3A
NEW YORK NY 10128

Officer/Director/Trustee Three

WAYNE CHARLES II
DIRECTOR
80 WEST 120TH STREET
NEW YORK NY 10027

Organization’s website WWW.ACTIVEPLUSNYC.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/4/2015
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
Organization’s purpose Charitable: Yes
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 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
Signature Title
Signature Date

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