FORM 1023-EZ for SILVERBACK ACADEMY

Field Data
EIN 46-5707886
Case Number EO-2016106-000122
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SILVERBACK ACADEMY
Organization’s Mailing Address 385 CORTLAND
City HIGHLAND PARK
State MI
ZIP 48203
Accounting period End 12
Primary contact name GLENN WASHINGTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GLENN WASHINGTON
CHAIRMAN
385 CORTLAND
HIGHLAND PARK MI 48203

Officer/Director/Trustee Two

CARLTON CLYBURN
VICE CHAIR
59 RHODE ISLAND
HIGHLAND PARK MI 48203

Officer/Director/Trustee Three

BREANNA BARNES
SECRETARY
20430 SCHAEFER
DETROIT MI 48235

Officer/Director/Trustee Four

JEFFERY JOHNSON
TREASURER
18330 BIRCHCREST
DETROIT MI 48221

Organization’s website WWW.HPSILVERBACKACADEMY.ORG
Organization’s email SILVERBACKACADEMY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/3/2014
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
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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