FORM 1023-EZ for AMPLIFY NETWORK INC

Field Data
EIN 83-2479931
Case Number EO-2018346-000336
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AMPLIFY NETWORK INC
Organization’s Mailing Address 3316 VALLEY FOREST DRIVE
City UPPER MARLBORO
State MD
ZIP 20772
Accounting period End 12
Primary contact name JACQUELINE SAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERENCE SAMS
PRESIDENT
3316 VALLEY FOREST DRIVE
UPPER MARLBORO MD 20772

Officer/Director/Trustee Two

JACQUELINE SAMS
VICE PRESIDENT
3316 VALLEY FOREST DRIVE
UPPER MARLBORO MD 20772

Officer/Director/Trustee Three

SHANTELL SANDERS
TREASURER
10716 FLYING CHANGE COURT
UPPER MARLBORO MD 20772

Officer/Director/Trustee Four

TAMARA GEORGE
SECRETARY
2126 TURLEYGREEN
UPPER MARLBORO MD 20772

Officer/Director/Trustee Five

JAHMEL DEVERGER
BOARD MEMBER
9600 MILESTONE WAY APT 3008
COLLEGE PARK MD 20724

Organization’s website
Organization’s email AMPLIFYNETWORK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/4/18
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A30 - Media, Communications Organizations
Organization’s purpose Charitable: No
Religious: Yes
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 JACQUELINE SAMS
Signature Title VICE PRESIDENT
Signature Date 12/10/18

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