FORM 1023-EZ for CROSSTOWN KIDS CROSSTOWN HOME

Field Data
EIN 84-3750188
Case Number EO-2020281-000054
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CROSSTOWN KIDS CROSSTOWN HOME
Organization’s Mailing Address 20016 SUNSET DR
City WARRENSVILLE HEIGHTS
State OH
ZIP 44122
Accounting period End 12
Primary contact name MARLON DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARLON DAVIS
CEO/TREASURER
20016 SUNSET DR
WARRENSVILLE HEIGHTS OH 44122

Officer/Director/Trustee Two

CHARMAINE RAY
VICE PRESIDENT
3382 E 103
CLEVELAND OH 44104

Officer/Director/Trustee Three

LATRAR JACKSON
SECRETARY
17218 GROVEWOOD
CLEVELAND OH 44119

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/2019
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service 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 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 MARLON DAVIS
Signature Title CEO/TREASURER
Signature Date 10/5/2020

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