FORM 1023-EZ for EMPOWERED TO FLOURISH

Field Data
EIN 83-3974789
Case Number EO-2019084-000283
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMPOWERED TO FLOURISH
Organization’s Mailing Address 8780 19TH STREET STE 176
City ALTA LOMA
State CA
ZIP 91701
Accounting period End 12
Primary contact name TAMARA A ELLISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMARA ELLISON
EXECUTIVE DIRECTOR
8780 19TH STREET STE 176
ALTA LOMA CA 91701

Officer/Director/Trustee Two

LIANA ALISHON
TREASURER
8780 19TH STREET STE 176
ALTA LOMA CA 91701

Officer/Director/Trustee Three

LORRAINE BRANCH
SECRETARY
8780 19TH STREET STE 176
ALTA LOMA CA 91701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TAMARA ELLISON
Signature Title EXECUTIVE DIRECTOR
Signature Date 3/20/19

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