FORM 1023-EZ for STAY MOTIVATED INC

Field Data
EIN 83-0530890
Case Number EO-2018317-000068
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STAY MOTIVATED INC
Organization’s Mailing Address 12418 STOWE ACRES DRIVE
City CHARLOTTE
State NC
ZIP 28262
Accounting period End 12
Primary contact name C MARIA MACON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REGINALD SEAN TERRY
PRESIDENT
12418 STOWE ACRES DRIVE
CHARLOTTE NC 28262

Officer/Director/Trustee Two

ANTHONY EDMONDS
VICE PRESIDENT
12358 HONEY HILL LANE
CHARLOTTE NC 28273

Officer/Director/Trustee Three

LORRAINE TERRY
SECRETARY
7516 BLYTHWOOD LANE
CHARLOTTE NC 28227

Officer/Director/Trustee Four

KEVIN GILLIARD
TREASURER
808 HAWTHORNE LANE 330
CHARLOTTE NC 28204

Officer/Director/Trustee Five

DARRELL ALEXANDER
DIRECTOR
10021 CLOISTERS CLUB LANE 108
CHARLOTTE NC 28278

Organization’s website
Organization’s email REGINALDSEANTERRY@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/5/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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 REGINALD SEAN TERRY
Signature Title PRESIDENT
Signature Date 11/8/18

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