FORM 1023-EZ for JEFFERSON POST GRADUATE-MENTORING PROGRAM

Field Data
EIN 82-5509171
Case Number EO-2018281-000006
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JEFFERSON POST GRADUATE-MENTORING PROGRAM
Organization’s Mailing Address 732 71ST STREET SOUTH
City BIRMINGHAM
State AL
ZIP 35206-5407
Accounting period End 12
Primary contact name LORENZO PETTY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAM ANSLEY
DIRECTOR
4708 7TH AVENUE
BIRMINGHAM AL 35224-1969

Officer/Director/Trustee Two

SONJA WATTS
DIRECTOR
2807 WILDWOOD CROSSINGS
BIRMINGHAM AL 35211-6406

Officer/Director/Trustee Three

SONYA WILLIAMS
DIRECTOR
1216 AVENUE G ENSLEY
BIRMINGHAM AL 35218-1159

Officer/Director/Trustee Four

LORENZO PETTY
CHIEF EXECUTIVE OFFICER
732 71ST STREET SOUTH
BIRMINGHAM AL 35206-5407

Officer/Director/Trustee Five

EMORY MAULDIN
DIRECTOR
1800 GOREE PLACE
BIRMINGHAM AL 35211-3870

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/10/18
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 EMORY MAULDIN
Signature Title DIRECTOR
Signature Date 10/3/18

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