FORM 1023-EZ for TRIPLE THREAT FITNESS AND ENRICHMENT

Field Data
EIN 82-1278503
Case Number EO-2017116-000218
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TRIPLE THREAT FITNESS AND ENRICHMENT
Organization’s Mailing Address 5739 OBSERVATION CT STE 120
City COLORADO SPRINGS
State CO
ZIP 80916
Accounting period End 12
Primary contact name CHARLES LEVERETTE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES LEVERETTE
EXECUTIVE DIRECTOR
5739 OBSERVATION CT SUITE 120
COLORADO SPRINGS CO 80916

Officer/Director/Trustee Two

LUSHANDA LEVERETTE
SECRETARY
5739 OBSERVATION CT SUITE 120
COLORADO SPRINGS CO 80916

Officer/Director/Trustee Three

PATIENCE KABWASA
TREASURER
5739 OBSERVATION CT SUITE 120
COLORADO SPRINGS CO 80916

Organization’s website
Organization’s email TRIPLETHREATGYM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/24/2017
Organization Incorporation State CO
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 No
One Third Support Gifts Yes
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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