FORM 1023-EZ for HOOPS4LYFE

Field Data
EIN 47-2258939
Case Number EO-2017030-000432
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOOPS4LYFE
Organization’s Mailing Address 3931 HARWOOD STREET
City WINSTON-SALEM
State NC
ZIP 27105
Accounting period End 12
Primary contact name BRITTANY WARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRITTANY WARD
PRESIDENT/ CEO
3931 HARWOOD STREET
WINSTON-SALEM NC 27105

Officer/Director/Trustee Two

ADA HARSHAW
ACCOUNTANT
4293 OAK POINT DRIVE
WINSTON-SALEM NC 27106

Officer/Director/Trustee Three

WILLIE COKER
DIRECTOR
5352 KINGS WELL DRIVE
WINSTON-SALEM NC 27106

Officer/Director/Trustee Four

SHANISE CRAWFORD
SECRETARY
113 BETHABARA POINTE CIRCLE
WINSTON-SALEM NC 27106

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/26/2014
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence Yes
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More Yes
Gaming Activity Yes
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
Signature Title
Signature Date

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