FORM 1023-EZ for ADT HBCU ALLIANCE INC

Field Data
EIN 82-2641482
Case Number EO-2017244-000108
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ADT HBCU ALLIANCE INC
Organization’s Mailing Address 2627 NW 33RD ST APT 2206
City OAKLAND PARK
State FL
ZIP 33147
Accounting period End 7
Primary contact name DONTRELL DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONTRELL DAVIS
VPFO
2627 NW 33RD ST APT 2206
OAKLAND PARK FL 33309

Officer/Director/Trustee Two

ANTHONY BELL
VPEA
150 NE 17TH CT
BOYNTON BEACH FL 33435

Officer/Director/Trustee Three

TAJI WHITE
VPMP
1110 BALLPARK LANE APT 5105
LAWRENCEVILLE GA 30043

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/25/2017
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B29 - Charter Schools
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 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
Signature Title
Signature Date

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