FORM 1023-EZ for URBAN THERAPY COMMUNITY DEVELOPMENTINC

Field Data
EIN 83-3675571
Case Number EO-2019112-000414
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name URBAN THERAPY COMMUNITY DEVELOPMENTINC
Organization’s Mailing Address 5450 JOHNSON STREET
City MERRILLVILLE
State IN
ZIP 46410
Accounting period End 12
Primary contact name BENTLEY ELLIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BENTLEY ELLIS
PRESIDENT
5450 JOHNSON STREET
MERRILLVILLE IN 46410

Officer/Director/Trustee Two

VERONICA COLLINS
VICE PRESIDENT
5450 JOHNSON STREET
MERRILLVILLE IN 46410

Officer/Director/Trustee Three

LITA THOMAS
TREASURER
5450 JOHNSON STREET
MERRILLVILLE IN 46410

Officer/Director/Trustee Four

NANCY THOMAS
SECRETARY
5450 JOHNSON STREET
MERRILLVILLE IN 46410

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/28/19
Organization Incorporation State IN
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: 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 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 BENTLEY ELLIS
Signature Title PRESIDENT
Signature Date 4/18/19

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