FORM 1023-EZ for ROOTS UPLIFTED INC

Field Data
EIN 81-2827857
Case Number EO-2016160-000216
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROOTS UPLIFTED INC
Organization’s Mailing Address 42 WILLARD DRIVE
City BERNHARDS BAY
State NY
ZIP 13028
Accounting period End 12
Primary contact name DARLENE BAKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DARLENE BAKER
PRESIDENT
42 WILLARD DRIVE
BERNHARDS BAY NY 13028

Officer/Director/Trustee Two

VALERIE ESCOFFERY
VICE PRESIDENT
523 WESTMORELAND AVENUE
SYRACUSE NY 13210

Officer/Director/Trustee Three

CHRISTAL GILES
TREASURER
320 FURMAN STREET
SYRACUSE NY 13205

Officer/Director/Trustee Four

NICOLE ALMAN
SECRETARY
21654S REDWOOD LANE
WATERTOWN NY 13601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/20/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O51 - Youth Community Service Clubs
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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