FORM 1023-EZ for URBAN STEM ACADEMY

Field Data
EIN 47-2642736
Case Number EO-2015314-000295
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name URBAN STEM ACADEMY
Organization’s Mailing Address 2147 MELL ST
City SAVANNAH
State GA
ZIP 31415
Accounting period End 12
Primary contact name PATRICK BENTLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PATRICK BENTLEY
EXECUTIVE DIRECTOR
1801 LLOYD ST
SAVANNAH GA 31405

Officer/Director/Trustee Two

GEOFFREY ALLS
DIRECTOR
618 EAST 48TH ST
SAVANNAH GA 31405

Officer/Director/Trustee Three

JONATHAN LAMBRIGHT
DIRECTOR
3219 COLLEGE ST
SAVANNAH GA 31404

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B20 - Elementary, Secondary Education, K - 12
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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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