FORM 1023-EZ for THE PAULA BLAKE EMPOWERMENT INITIATIVE

Field Data
EIN 81-3388107
Case Number EO-2016223-000075
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE PAULA BLAKE EMPOWERMENT INITIATIVE
Organization’s Mailing Address 5833 S GOLDENROD SUITE B 151
City ORLANDO
State FL
ZIP 32822
Accounting period End 12
Primary contact name ARLENE BLAKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ARLENE BLAKE
DIRECTOR
1964 EXCALIBUR DRIVE
ORLANDO FL 32822

Officer/Director/Trustee Two

ADAM BARNES
DIRECTOR
4755 ANDERSON ROAD
ORLANDO FL 32812

Officer/Director/Trustee Three

SAMANTHA GROSS
DIRECTOR
15618 MONTESINO DRIVE
ORLANDO FL 32828

Officer/Director/Trustee Four

FIDELIS MUUKA
DIRECTOR
8999 VICTORIA ISLE PL
ORLANDO FL 32929

Officer/Director/Trustee Five

TAMMIE DUNLAP
DIRECTOR
260 S OSCEOLA AVE APT 1001
ORLANDO FL 32801

Organization’s website
Organization’s email INFO@WOMENONTHEMOVEORLANDO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/2016
Organization Incorporation State FL
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: 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 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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