FORM 1023-EZ for SELF EMPOWER INC
| Field | Data |
|---|---|
| EIN | 84-2227533 |
| Case Number | EO-2020051-000261 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SELF EMPOWER INC |
| Organization’s Mailing Address | PO BOX 2123 |
| City | FOREST PARK |
| State | GA |
| ZIP | 30298 |
| Accounting period End | 12 |
| Primary contact name | BRIEANNA GARRETT |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
BRIEANNA GARRETT
CHIEF EXECUTIVE OFFICER
2155 KINGSWOOD DRIVE
FOREST PARK GA 30298
Officer/Director/Trustee Two
ERICA THOMAS
CHIEF FINANCIAL OFFICER
54 BETTY LANE
DOUGLASVILLE GA 30134
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/1/2019 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | S99 - Community Improvement, Capacity Building N.E.C. |
| Organization’s purpose | Charitable: Yes 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 | Yes |
| Donation of funds | Yes |
| Conducting Activities Outside of United States | No |
| Financial transactions with officers | Yes |
| 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 | ERICA THOMAS |
| Signature Title | CHIEF FINANCIAL OFFICER |
| Signature Date | 2/18/2020 |
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