FORM 1023-EZ for FULL CIRCLE YOUTH FOUNDATION

Field Data
EIN 47-2661448
Case Number EO-2015007-000266
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FULL CIRCLE YOUTH FOUNDATION
Organization’s Mailing Address 1280 RITCHIE ROAD
City CAPITOL HEIGHTS
State MD
ZIP 20743
Accounting period End 12
Primary contact name SAMUEL SCOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SAMUEL SCOTT
PRESIDENT
1280 RITCHIE ROAD
CAPITOL HEIGHTS MD 20743

Officer/Director/Trustee Two

INDYE SCOTT
BOARD MEMBER
12007 KINGSBROOKE STREET
BOWIE MD 20721

Officer/Director/Trustee Three

BRIAN WILLIAMS
BOARD MEMBER
1843 CEDARWOOD COURT
BOWIE MD 20785

Officer/Director/Trustee Four

SIMONE URSALA-STEVENS
BOARD MEMBER
5627 ALLENTOWN ROAD 203
CAMP SPRINGS MD 20746

Organization’s website WWW.FCMARTIALARTS.COM
Organization’s email SAMUELESCOTT@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/4/2013
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, 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 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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