FORM 1023-EZ for SELF EMPOWERMENT SYSTEM

Field Data
EIN 81-3911564
Case Number EO-2016273-000287
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SELF EMPOWERMENT SYSTEM
Organization’s Mailing Address PO BOX 154413
City WACO
State TX
ZIP 76715
Accounting period End 12
Primary contact name FLOYD LONG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FLOYD LONG
PRESIDENT, DIRECTOR
2405 JJ FLEWELLEN RD STE 602
WACO TX 76704

Officer/Director/Trustee Two

TYNNETTA MUHAMMAD
SECRETARY, DIRECTOR
917 HARLEM ST
WACO TX 76704

Officer/Director/Trustee Three

CLARISSA MUHAMMAD
TREASURER, DIRECTOR
503 N OAK DR
LACY LAKEVIEW TX 76705

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/19/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: No
Religious: No
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 Yes
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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