FORM 1023-EZ for QUEEN CITY CABARET

Field Data
EIN 84-2013857
Case Number EO-2019170-000126
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name QUEEN CITY CABARET
Organization’s Mailing Address 3729 EASTERN AVE APT 1
City CINCINNATI
State OH
ZIP 45226-2102
Accounting period End 6
Primary contact name MATTHEW UMPHREYS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW UMPHREYS
DIRECTOR
3729 EASTERN AVE APT 1
CINCINNATI OH 45226-2102

Officer/Director/Trustee Two

SARAH FOLSOM
DIRECTOR
4014 CARTER AVE
CINCINNATI OH 45212-3529

Organization’s website WWW.QUEENCITYCABARETCINCY.COM
Organization’s email QUEENCITYCABARETCINCY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/18/19
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
Organization’s purpose Charitable: No
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 Yes
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 SARAH FOLSOM
Signature Title DIRECTOR
Signature Date 6/16/19

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