FORM 1023-EZ for LIFT UP KC YOUTH ORGANIZATION

Field Data
EIN 82-2841948
Case Number EO-2017275-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFT UP KC YOUTH ORGANIZATION
Organization’s Mailing Address 7824 E 130TH COURT
City GRANDVIEW
State MO
ZIP 64030
Accounting period End 12
Primary contact name CLIFTON JEFFERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHIFFNEY DUKES
CEO-DIRECTOR
7824 E 130TH COURT
GRANDVIEW MO 64030

Officer/Director/Trustee Two

MONIQUE JOHNSON
CFO-ASST DIRECTOR FINANCE
7824 E 130TH COURT
GRANDVIEW MO 64030

Officer/Director/Trustee Three

CLIFTON JEFFERSON
COO-ASST DIRECTOR OPERATIONS
1438 N PRINCE EDWARD IS
OLATHE KS 66061

Organization’s website WWW.LIFTUPKCYOUTH.ORG
Organization’s email LIFTUPKCYOUTHORG@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/20/2017
Organization Incorporation State MO
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 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
Signature Title
Signature Date

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