FORM 1023-EZ for CONNECT YOUR COMMUNITY INSTITUTE

Field Data
EIN 82-0710800
Case Number EO-2017068-000455
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CONNECT YOUR COMMUNITY INSTITUTE
Organization’s Mailing Address 3100 ARCHWOOD AVENUE
City CLEVELAND
State OH
ZIP 44109-2526
Accounting period End 12
Primary contact name WILLIAM CALLAHAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM CALLAHAN
PRESIDENT AND DIRECTOR
3100 ARCHWOOD AVE
CLEVELAND OH 44109-2526

Officer/Director/Trustee Two

CHARLES MCDOWELL
TREASURER
3373 EAST 135TH STREET
CLEVELAND OH 44120-3957

Officer/Director/Trustee Three

AMY SHEON
SECRETARY
1961 LAKEVIEW AVENUE
ROKY RIVER OH 44116-2413

Officer/Director/Trustee Four

ADAM PERZYNSKI
NA
1119 SHEERBROOK DRIVE
CHAGRIN FALLS OH 44022-4136

Officer/Director/Trustee Five

SAMANTHA SCHARTMAN-CYCYK
NA
18093 HERITAGE TRAIL
STRONGSVILLE OH 44136-7079

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/19/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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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