FORM 1023-EZ for COMMUNITY IMPACT INC

Field Data
EIN 84-2645407
Case Number EO-2019365-000152
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY IMPACT INC
Organization’s Mailing Address 8334 LIBERTY ROAD
City WINDSOR MILL
State MD
ZIP 21244
Accounting period End 12
Primary contact name JAMEILAH BLOUNT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARI FLEMING
PRESIDENT
8334 LIBERTY RD
WINDSOR MD 21244

Officer/Director/Trustee Two

JASON NELSON
VICE-PRESIDENT
8334 LIBERTY RD
WINDSOR MIL MD 21244

Officer/Director/Trustee Three

STEPHANIE COURTS
SECRETARY
8334 LIBERTY RD
WINDSOR MILL MD 21244

Officer/Director/Trustee Four

JAMELIAH BLOUNT
TREASURER
8334 LIBERTY RD
WINDSOR MILL MD 21244

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/5/2019
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 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 SHARI FLEMING
Signature Title PRESIDENT
Signature Date 12/29/2019

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