FORM 1023-EZ for UNIQUELY SUCCESSFUL INC

Field Data
EIN 46-4692713
Case Number EO-2017034-000308
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UNIQUELY SUCCESSFUL INC
Organization’s Mailing Address 17219 SEQUOIA STREET 40
City HESPERIA
State CA
ZIP 92345
Accounting period End 12
Primary contact name JOHANNA WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHANNA WILLIAMS
PRESIDENT
17219 SEQUOIA ST 40
HESPERIA CA 92345

Officer/Director/Trustee Two

CHERRON PIERSON
SECRETARY
15137 CANYONVIEW CT
VICTORVILLE CA 92394

Officer/Director/Trustee Three

DEBORAH BOLTON
TREASURER
109 E FREDRICKS STREET
BARSTOW CA 92311

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/23/2013
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
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
Signature Title
Signature Date

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