FORM 1023-EZ for USA STAFFING IMPACT FOUNDATION

Field Data
EIN 87-1103202
Case Number EO-2021202-000189
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name USA STAFFING IMPACT FOUNDATION
Organization’s Mailing Address 135 TECHNOLOGY DRIVE SUITE 400
City CANONSBURG
State PA
ZIP 15317
Accounting period End 12
Primary contact name ANDY BIANCO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSH ROBERTS
PRESIDENT & DIRECTOR
45 EDGECLIFF RD
CARNEGIE PA 15106

Officer/Director/Trustee Two

ALEXANDRE BRITO
VICE PRESIDENT
135 TECHNOLOGY DRIVE SUITE 400
CANONSBURG PA 15317

Officer/Director/Trustee Three

LOGAN CARLISLE
TREASURER
135 TECHNOLOGY DRIVE SUITE 400
CANONSBURG PA 15317

Officer/Director/Trustee Four

JEREMY ODELL
SECRETARY
135 TECHNOLOGY DRIVE SUITE 400
CANONSBURG PA 15317

Organization’s website WWW.STAFFING-USA.COM
Organization’s email JROBERTS@STAFFING-USA.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/4/2021
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y12 - Fund Raising and/or Fund Distribution
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 JOSH ROBERTS
Signature Title PRESIDENT & DIRECTOR
Signature Date 7/19/2021

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