FORM 1023-EZ for CHAMPION MENTORING INC

Field Data
EIN 86-1713758
Case Number EO-2021085-000034
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHAMPION MENTORING INC
Organization’s Mailing Address 20236 CAPITAL LANE
City HAGERSTOWN
State MD
ZIP 21742
Accounting period End 12
Primary contact name SHELDON SPIVEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHELDON SPIVEY
PRESIDENT
20236 CAPITAL LANE
HAGERSTOWN MD 21742

Officer/Director/Trustee Two

SHELINA DRAKE
VICE PRESIDENT
20236 CAPITAL LANE
HAGERSTOWN MD 21742

Officer/Director/Trustee Three

SEAN SPIVEY
TREASURER
20236 CAPITAL LANE
HAGERSTOWN MD 21742

Officer/Director/Trustee Four

SHARON DAVIS
SECRETARY
20236 CAPITAL LANE
HAGERSTOWN MD 21742

Organization’s website
Organization’s email CHAMPIONMENTORING@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/30/2020
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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 SHELDON SPIVEY
Signature Title PRESIDENT
Signature Date 2/2/2021

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