FORM 1023-EZ for AMERICAN CAPOEIRA FOUNDATION

Field Data
EIN 47-1250928
Case Number EO-2016074-000164
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMERICAN CAPOEIRA FOUNDATION
Organization’s Mailing Address 2422 MADELINE MEADOW DR
City CHARLOTTE
State NC
ZIP 28217
Accounting period End 12
Primary contact name REBA BOWENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DOUG BLUE
BOARD OF DIRECTORS
1863 BASKINS RD
ROCK HILL SC 29730

Officer/Director/Trustee Two

FELIPE PAZ
BOARD OF DIRECTORS - SECRETARY
2272 REID POINTE AVE
INDIAN LAND SC 29707

Officer/Director/Trustee Three

ERIC WIENBRENNER
BOARD OF DIRECTORS - CHAIRMAN
1018 PATRICIANS LANE
MONROE NC 28110

Officer/Director/Trustee Four

ARISTIDES VALERIANO
PRESIDENT
823 YORKDALE DR
CHARLOTTE NC 28217

Officer/Director/Trustee Five

REBA BOWENS
TREASURER
2422 MADELINE MEADOW DR
CHARLOTTE NC 28217

Organization’s website WWW.AMERICANCAPOEIRAFOUNDATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/2014
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 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
Signature Title
Signature Date

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