FORM 1023-EZ for CULTIVATION ENTERPRISES INCORPORATED

Field Data
EIN 85-1235528
Case Number EO-2020164-000181
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CULTIVATION ENTERPRISES INCORPORATED
Organization’s Mailing Address 2102 GRAMERCY PARK DRIVE
City GREENSBORO
State NC
ZIP 27406
Accounting period End 12
Primary contact name MICA BAILEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ADARA A JOHNSON
PRESIDENT
2102 GRAMERCY PARK DRIVE
GREENSBORO NC 27406

Officer/Director/Trustee Two

PAMELA S MOYE
SECRETARY
518 LEITZEL AVENUE
GREENSBORO NC 27406

Officer/Director/Trustee Three

MICHAEL J CLINTON JR
TREASURER
3306 REHOBETH CHURCH RAOD
GREENSBORO NC 27406

Officer/Director/Trustee Four

KEYONA BARRETT
TRANSITIONAL LIVING DIRECTOR
6716 BARTON CREEK DRIVE
WHITSETT NC 27377

Officer/Director/Trustee Five

MASETA DORLEY
GLOBAL CONSULTANT
PO BOX 2133
GREENSBORO NC 27402

Organization’s website N/A
Organization’s email CULTIVATIONENT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 Yes
Donation of funds Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ADARA A JOHNSON
Signature Title PRESIDENT
Signature Date 6/10/2020

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