FORM 1023-EZ for GLENVILLE PANTHERS YOUTH MENTORINGORGANIZTION

Field Data
EIN 81-5175226
Case Number EO-2020051-000439
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GLENVILLE PANTHERS YOUTH MENTORINGORGANIZTION
Organization’s Mailing Address 1062 PEMBROOK ROAD
City CLEVELAND HEIGHTS
State OH
ZIP 44112
Accounting period End 12
Primary contact name RUSSELL HAMBLINE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUSSELL HAMBLINE
TRUSTEE
1062 PEMBROOK ROAD
CLEVELAND HEIGHTS OH 44112

Officer/Director/Trustee Two

DESEAN PERKINS
PRESIDENT
16383 EUCLID AVENUE
EAST CLEVELAND OH 44112

Officer/Director/Trustee Three

ANN PERKINS
OFFICER
26241 LAKESHORE BLVD
EUCLID OH 44132

Officer/Director/Trustee Four

RHONDA CALDWELL
OFFICER
20301 CRYSTAL AVENUE
EUCLID OH 44132

Officer/Director/Trustee Five

JAYSON HEAGGANS
SECRETARY
5269 SMITH ROAD
BRROKPARK OH 44142

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O23 - Boys and Girls Clubs (Combined)
Organization’s purpose Charitable: Yes
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 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 Yes
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 DESEAN PERKINS
Signature Title PRESIDENT
Signature Date 2/18/2020

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