FORM 1023-EZ for CLEAN SLATE INDUSTRIES
| Field | Data |
|---|---|
| EIN | 86-3019160 |
| Case Number | EO-2021111-000223 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | CLEAN SLATE INDUSTRIES |
| Organization’s Mailing Address | 1381 SKYWAY DR |
| City | YPSILANTI |
| State | MI |
| ZIP | 48197 |
| Accounting period End | 12 |
| Primary contact name | GOWRI KRISHNA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
STEVEN HALL
DIRECTOR
1381 SKYWAY DR
YPSILANTI MI 48197
Officer/Director/Trustee Two
PRISCILLA CORTEZ
MENTAL HEALTH DIRECTOR
8386 LAKEVIEW DR
YPSILANTI MI 48198
Officer/Director/Trustee Three
TIM LANKERD
MENTAL HEALTH CONSULTANT
14382 EDGEWATER DR
GREGORY MI 48137
Officer/Director/Trustee Four
REGINA WINBORN
EDUCATION DIRECTOR
7425 WILLIS RD
YPSILANTI MI 48197
| Organization’s website | |
|---|---|
| Organization’s email | HALLS@EWASHTENAW.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/26/2021 |
| Organization Incorporation State | MI |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | I21 - Delinquency Prevention |
| 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 | Yes |
| Compensation of Officer director trustee | No |
| Donation of funds | Yes |
| Conducting Activities Outside of United States | No |
| Financial transactions with officers | Yes |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | Yes |
| Disaster relief assistance | Yes |
| 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 | STEVEN HALL |
| Signature Title | DIRECTOR |
| Signature Date | 4/19/2021 |
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