FORM 1023-EZ for UAREACHAMPION EMPOWERMENT NETWORK GROUP INC

Field Data
EIN 85-0812440
Case Number EO-2020120-000046
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name UAREACHAMPION EMPOWERMENT NETWORK GROUP INC
Organization’s Mailing Address 1809 ALBEMARLE ROAD APT B36
City BROOKLYN
State NJ
ZIP 11226
Accounting period End 12
Primary contact name ASIA DOSREIS-WHITEHEAD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAMOR WHITEHEAD
DIRECTOR
1 SIPPORTA LANE
PARAMUS NJ

Officer/Director/Trustee Two

ERIKA HALL
CHIEF ADMINISTRATOR
586 PARK AVE APT 6A
BROOKLYN NY 11206

Officer/Director/Trustee Three

STACEY PEART
SECRETARY
80 AMES ROAD
BROCKTON NY 02302

Officer/Director/Trustee Four

KEITH DOSREIS SR
TREASURER
1809 ALBEMARLE ROAD SUITE B36
BROOKLYN NY 11226

Officer/Director/Trustee Five

BRIAN FIGEROUX
ATTORNEY
26 COURT STREET SUITE 701
BROOKLYN NY 11201

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/2020
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KEITH DOSREIS SR
Signature Title TREASURER
Signature Date 4/25/2020

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