FORM 1023-EZ for UPLIFT WEIGHTLIFTING

Field Data
EIN 84-2814004
Case Number EO-2019238-000711
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name UPLIFT WEIGHTLIFTING
Organization’s Mailing Address 3705 WEST ALTGELD APT 2
City CHICAGO
State IL
ZIP 60647
Accounting period End 6
Primary contact name CHARLES CANNON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES CANNON JR
PRESIDENT
3705 WEST ALTGELD APT 2
CHICAGO IL 60647

Officer/Director/Trustee Two

JENN JACOBS
DIRECTOR
1162 STARWOOD PASS
LAKE IN THE HILLS IL 60156

Officer/Director/Trustee Three

AVERY SCURLOCK
DIRECTOR
699 JOHN STREET
SEATTLE WA 98109

Officer/Director/Trustee Four

EMIR METOVIC
DIRECTOR
8933 EWING AVE
EVANSTON IL 60203

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/4/17
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I21 - Delinquency Prevention
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 Yes
Donation of funds Yes
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 CHARLES CANNON JR
Signature Title PRESIDENT
Signature Date 8/24/19

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