FORM 1023-EZ for EMPOWERED ARROW INC

Field Data
EIN 83-4321935
Case Number EO-2019127-000113
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMPOWERED ARROW INC
Organization’s Mailing Address 320 SOUTH ROAD
City SCOTTSVILLE
State NY
ZIP 14546
Accounting period End 12
Primary contact name JOHN F WHITING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONALD H HICKEL JR
DIRECTOR
320 SOUTH ROAD
SCOTTSVILLE NY 14546

Officer/Director/Trustee Two

LYNN GIRVEN
DIRECTOR
360 SOUTH ROAD
SCOTTSVILLE NY 14546

Officer/Director/Trustee Three

DIANE ROMANO
DIRECTOR
8359 PEACHEY ROAD
BERGEN NY 14428

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/19
Organization Incorporation State NY
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: 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DONALD H HICKEL JR
Signature Title DIRECTOR
Signature Date 5/3/19

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