FORM 1023-EZ for ELEVATE UPSTATE INC

Field Data
EIN 82-3622768
Case Number EO-2018037-000141
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ELEVATE UPSTATE INC
Organization’s Mailing Address 313 HORNADY DRIVE
City SYRACUSE
State NY
ZIP 13209
Accounting period End 12
Primary contact name CASEY ROTACH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMANDA SCHNORF
DIRECTOR
11 LONGSWORTH DRIVE
ROCHESTER NY 14625

Officer/Director/Trustee Two

CASEY ROTACH
OFFICER
313 HORNADY DRIVE
SYRACUSE NY 13209

Officer/Director/Trustee Three

SHARON JOSLYN
DIRECTOR
43 FARMBROOK DRIVE
FARMINGTON NY 14425

Officer/Director/Trustee Four

COLTON ERICSON
DIRECTOR
220 MOONEY AVE
SYRACUSE NY 13206

Officer/Director/Trustee Five

BARRETT GRACHUS
DIRECTOR
792 LAUREN COURT
WEBSTER NY 14580

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/18/18
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T70 - Fund Raising Organizations That Cross Categories
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 Yes
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 CASEY ROTACH
Signature Title OFFICER
Signature Date 2/4/18

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