FORM 1023-EZ for ATNSC CENTER FOR HEALING AND CREATIVE LEADERSHIP

Field Data
EIN 81-5288866
Case Number EO-2018219-000179
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ATNSC CENTER FOR HEALING AND CREATIVE LEADERSHIP
Organization’s Mailing Address 3 SEVERANCE CIRCLE UNIT 18742
City CLEVELAND HEIGHTS
State OH
ZIP 44118-742
Accounting period End 5
Primary contact name M CARMEN LANE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

M CARMEN LANE
DIRECTOR
2681 EAST 127TH STREET UPPER
CLEVELAND OH 44120-1425

Officer/Director/Trustee Two

KIRBY BROADNAX
TRUSTEE
2684 EAST 128TH STREET UPPER
CLEVELAND OH 44120-1425

Officer/Director/Trustee Three

MISTY LUMINAIS
TRUSTEE
7615 COLGATE AVENUE
CLEVELAND OH 44102-1

Officer/Director/Trustee Four

ELFI MARTINEZ
TRUSTEE
2191 CHESTNUT AVENUE UNIT 203
LONG BEACH CA 90806-4564

Officer/Director/Trustee Five

SCOTT BUQUOR
TRUSTEE
479 WALNUT STREET
NEWTON MA 2460-2281

Organization’s website WWW.ATNSC.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/5/17
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
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 M CARMEN LANE
Signature Title DIRECTOR
Signature Date 8/5/18

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