FORM 1023-EZ for HISPANIC LEADERSHIP FORUM OF HAMPTON ROADS INC

Field Data
EIN 14-1988699
Case Number EO-2016013-000459
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HISPANIC LEADERSHIP FORUM OF HAMPTON ROADS INC
Organization’s Mailing Address 1725 LAKE CHRISTOPHER DRIVE
City VIRGINIA BEACH
State VA
ZIP 23464-7901
Accounting period End 12
Primary contact name LUIS RIVERA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LUIS RIVERA
PRESIDENT
1725 LAKE CHRISTOPHER DR
VIRGINIA BEACH VA 23464-7901

Officer/Director/Trustee Two

ALICIA BOBULINSKI
VICE PRESIDENT
990 KELSO COURT
VIRGINIA BEACH VA 23464-3055

Officer/Director/Trustee Three

DENEEN JARAMILLO
SECRETARY/TREASURER
2056 SILVER LAKE DRIVE
VIRGINIA BEACH VA 23464-8942

Officer/Director/Trustee Four

ENRIQUE ORTIZ
DIRECTOR
3184 GUARDHOUSE CIRCLE
VIRGINIA BEACH VA 23456-3185

Officer/Director/Trustee Five

OLGA TORRES
DIRECTOR
1904 HAVERHILL COURT
VIRGINIA BEACH VA 23453-5545

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/13/2007
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
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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