FORM 1023-EZ for SHAPE LIVES INTERNATIONAL NJ NON-PROFIT CORPORATION

Field Data
EIN 82-1276699
Case Number EO-2017117-000393
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHAPE LIVES INTERNATIONAL NJ NON-PROFIT CORPORATION
Organization’s Mailing Address 455 ELIZABETH AVENUE APT 16B
City NEWARK
State NJ
ZIP 07112
Accounting period End 12
Primary contact name RICHARD Y ADOM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD ADOM
DIRECTOR
455 ELIZABETH AVE APT 16B
NEWARK NJ 07112

Officer/Director/Trustee Two

SARAH NKRUMAH
DIRECTOR
455 ELIZABETH AVE APT 16B
NEWARK NJ 07112

Officer/Director/Trustee Three

PRINCE OSEI - AKYEAMPONG
DIRECTOR
126 PORT AVE
ELIZABETH NJ 07206

Organization’s website
Organization’s email SHAPELIVESINTERNATIONALUS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/24/2017
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K01 - Alliance/Advocacy Organizations
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
Signature Title
Signature Date

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