FORM 1023-EZ for QUERENCIA LEADERSHIP INC

Field Data
EIN 87-1438001
Case Number EO-2021183-000375
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name QUERENCIA LEADERSHIP INC
Organization’s Mailing Address 485 NEWPORT BRIDGE ROAD
City PINE ISLAND
State NY
ZIP 12508
Accounting period End 12
Primary contact name HANS HAGEMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAREN BEST
CHAIR
954 EAST 15TH STREET 3A
BROOKLYN NY 11230

Officer/Director/Trustee Two

ALEXIS RAMOS
SECRETARY
265 WEST 123RD STREET 2F
NEW YORK NY 10027

Officer/Director/Trustee Three

ANTHONY ACOSTA
TREASURER
2529 MORGAN AVENUE
BRONX NY 10469

Officer/Director/Trustee Four

HANS HAGEMAN
PRESIDENT
485 NEWPORT BRIDGE ROAD
PINE ISLAND NY 10969

Organization’s website
Organization’s email HANS@HANSHAGEMAN.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/2021
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
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 HANS HAGEMAN
Signature Title PRESIDENT
Signature Date 6/29/2021

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