FORM 1023-EZ for 21ST CENTURY COMMUNITY LEADERS

Field Data
EIN 83-1844046
Case Number EO-2019224-000428
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 21ST CENTURY COMMUNITY LEADERS
Organization’s Mailing Address 3580 INNOVATION WAY
City HERMITAGE
State PA
ZIP 16148
Accounting period End 12
Primary contact name STANLEY T BOOKER ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN BUCHENIC
DIRECTOR
324 NORTH MAIN STREET
HUBBARD OH 44425

Officer/Director/Trustee Two

KARA MILD
DIRECTOR
1501 SOUTH NESHANNOCK ROAD
HERMITAGE PA 16148

Officer/Director/Trustee Three

STEVEN EDWARDS
DIRECTOR
317 LUNN BOULEVARD
FARRELL PA 16121

Officer/Director/Trustee Four

ALIJAH HASAN-DOUGLAS
DIRECTOR
1101 BOND STREET
FARRELL PA 16121

Officer/Director/Trustee Five

STEVEN BREWER
DIRECTOR
147 SHENANGO AVENUE
SHARON PA 16146

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/15/19
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R30 - Intergroup, Race Relations
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 ALIJAH HASAN-DOUGLAS
Signature Title DIRECTOR
Signature Date 8/9/19

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