FORM 1023-EZ for EMPOWERING OUR COMMUNITY FOR SUCCESS

Field Data
EIN 47-2643930
Case Number EO-2015212-000122
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EMPOWERING OUR COMMUNITY FOR SUCCESS
Organization’s Mailing Address 1764 QUEENSTOWN DR
City SAN JOSE
State CA
ZIP 95132
Accounting period End 9
Primary contact name DANIEL CHAVEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DANIEL CHAVEZ
C.E.O
1764 QUEENSTOWN DR
SAN JOSE CA 95132

Officer/Director/Trustee Two

RON LANDEROS
VICE CHAIR
7089 VIA RAMADA
SAN JOSE CA 95110

Officer/Director/Trustee Three

JACKIE DOMINGUEZ
TREASURER
1764 QUEENSTOWN DR
SAN JOSE CA 95132

Officer/Director/Trustee Four

ROBERTO LANDEROS
SECRETARY
2199 PAPPAS PLACE
HAYWARD CA 94542

Officer/Director/Trustee Five

TONY RODRIGUEZ
BOARD MEMBER
233 SOUTH 22ND
SAN JOSE CA 95116

Organization’s website
Organization’s email EMPOWERINGOURCOMMUNITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/17/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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
Signature Title
Signature Date

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