FORM 1023-EZ for URBAN CITY IMPACT

Field Data
EIN 86-2123909
Case Number EO-2021097-000555
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name URBAN CITY IMPACT
Organization’s Mailing Address 126 TRESLYN TRACE
City HAMPTON
State VA
ZIP 23666
Accounting period End 12
Primary contact name JOSHUA MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSHUA MILLER
PRESIDENT
126 TRESLYN TRACE
HAMPTON VA 23666

Officer/Director/Trustee Two

LEAH RUIZ
SECRETARY
103 RICHNECK ROAD
NEWPORT NEWS VA 23608

Officer/Director/Trustee Three

ASHLEY PRESTON
TREASURER
24 KETTERING LANE
HAMPTON VA 23666

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/17/2021
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O55 - Youth Development - Religious Leadership
Organization’s purpose Charitable: Yes
Religious: Yes
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 JOSHUA MILLER
Signature Title PRESIDENT
Signature Date 3/12/2021

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