FORM 1023-EZ for XTREME RISE INC

Field Data
EIN 47-4890651
Case Number EO-2015272-000222
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name XTREME RISE INC
Organization’s Mailing Address 5004 EAST FOWLER AVENUE
City TAMPA
State FL
ZIP 33617
Accounting period End 12
Primary contact name SHAUNETTE STOKES ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CEDRICKA SPENCER
PRESIDENT
8913 BRIDGEFORD OAKS DR
TAMPA FL 33637

Officer/Director/Trustee Two

XIOMARA GUZMAN GOMEZ
DIRECTOR
2418 MIRADOR LAND
WESLEY CHAPEL FL 33544

Officer/Director/Trustee Three

SHENITA MALLOY
DIRECTOR
5301 REFLECTIONS CLUB DR
TAMPA FL 33634

Officer/Director/Trustee Four

MIRLANDE ST JUSTE ROMULUS
DIRECTOR
710 17TH STREET NE
WINTER HAVEN FL 33881

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/15/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J22 - Vocational Training
Organization’s purpose Charitable: No
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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