FORM 1023-EZ for ELEVATION 360 INC

Field Data
EIN 84-1792508
Case Number EO-2020147-000375
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ELEVATION 360 INC
Organization’s Mailing Address 9766 KAMENA CIRCLE
City BOYNTON BEACH
State FL
ZIP 33436
Accounting period End 11
Primary contact name PATRICE BARBER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICE BARBER-JONES
PRESIDENT
9766 KAMENA CIRCLE
BOYNTON BEACH FL 33436

Officer/Director/Trustee Two

WILLIE JONES
OFFICER
5096 NW 5TH STREET
BOYNTON BEACH FL 33445

Officer/Director/Trustee Three

PEARL THOMAS
OFFICER
5345 BLUEBERRY HILL AVENUE
LAKE WORTH FL 33463

Officer/Director/Trustee Four

PERTICIA BARBER
OFFICER
220 ROSS DRIVE
DELRAY BEACH FL 33445

Officer/Director/Trustee Five

KIMBERLY YOUNG
OFFICER
428 NE 14TH AVENUE
BOYNTON BEACH FL 33435

Organization’s website ELEVATION360.ORG
Organization’s email ELEVATION360LLC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/25/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O55 - Youth Development - Religious Leadership
Organization’s purpose Charitable: No
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
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 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 PATRICE BARBER-JONES
Signature Title PRESIDENT
Signature Date 5/21/2020

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