FORM 1023-EZ for IMPACT & ELEVATE

Field Data
EIN 84-2452400
Case Number EO-2019219-000238
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name IMPACT & ELEVATE
Organization’s Mailing Address 38713 TIERRA SUBIDA AVE NUM 264
City PALMDALE
State CA
ZIP 93551
Accounting period End 12
Primary contact name SOPHRENIA BARNES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SOPHRENIA BARNES
PRESIDENT
38713 TIERRA SUBIDA AVE NUM 264
PALMDALE CA 93551

Officer/Director/Trustee Two

DEANDREA KNIGHT
SECRETARY/TREASURER
38235 VILLETTE ST
PALMDALE CA 93551

Organization’s website
Organization’s email SMBARNES1127@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/19/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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 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 SOPHRENIA BARNES
Signature Title PRESIDENT
Signature Date 8/5/19

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