FORM 1023-EZ for THE EMPOWERMENT PLACE INC

Field Data
EIN 46-5626241
Case Number EO-2018232-000629
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE EMPOWERMENT PLACE INC
Organization’s Mailing Address 1551 ROHDE AVE
City BERKELEY
State IL
ZIP 60163
Accounting period End 12
Primary contact name LYNETTA DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LYNETTA DAVIS
PRESIDENT
1551 ROHDE AVE
BERKELEY IL 60163

Officer/Director/Trustee Two

ELIZABETH TAYLOR
TREASURER
2030 SOUTH 20TH AVE
BROADVIEW IL 60155

Officer/Director/Trustee Three

THAD WILLIAMS
VICE PRESIDENT
2272 WINDSOR LANE
COUNTRY CLUB HILLS IL 60478

Officer/Director/Trustee Four

RHONDA ADMAS THOMAS
CHAIR
14237 SE STEPHENS
PORTLAND OR 97233

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/14
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LYNETTA DAVIS
Signature Title PRESIDENT
Signature Date 8/18/18
EIN 46-5626241
Case Number EO-2015257-000247
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE EMPOWERMENT PLACE INC
Organization’s Mailing Address PO BOX 7611
City WESTCHESTER
State IL
ZIP 60154
Accounting period End 3
Primary contact name ELIZABETH TAYLOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LYNETTA DAVIS
PRESIDENT, DIRECTOR
3109 MONROE ST
BELLWOOD IL 60104

Officer/Director/Trustee Two

ELIZABETH TAYLOR
TREASURER, SECRETARY, DIRECTOR
2030 SOUTH 20TH AVE
BROADVIEW IL 60155

Officer/Director/Trustee Three

THAD WILLIAMS
VICE PRESIDENT, DIRECTOR
2272 WINDSOR LN
COUNTRY CLUB HILLS IL 60478

Officer/Director/Trustee Four

RHONDA ADAMS THOMAS
CHAIR, DIRECTOR
14237 SE STEPHENS ST
PORTLAND OR 97233

Officer/Director/Trustee Five

BARBARA VARNADO
VICE CHAIR, DIRECTOR
PO BOX 7611
WESTCHESTER IL 60154

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/2014
Organization Incorporation State IL
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: 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 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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