FORM 1023-EZ for SUCCESS STORY

Field Data
EIN 84-3232054
Case Number EO-2019277-000828
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUCCESS STORY
Organization’s Mailing Address 3209 S RHODES AVE
City CHICAGO
State IL
ZIP 60616
Accounting period End 12
Primary contact name ALEXIS HART MCDOWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATE FLINT
DIRECTOR
3209 S RHODES AVE
CHICAGO IL 60616

Officer/Director/Trustee Two

DWAYNE EVERETT
DIRECTOR
3209 S RHODES AVE
CHICAGO IL 60616

Officer/Director/Trustee Three

SOPHIA LOVE
DIRECTOR
3209 S RHODES AVE
CHICAGO IL 60616

Officer/Director/Trustee Four

CICELY GLANTON
DIRECTOR
3209 S RHODES AVE
CHICAGO IL 60616

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/30/19
Organization Incorporation State IL
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 Yes
Donation of funds Yes
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 CICELY GLANTON
Signature Title DIRECTOR
Signature Date 10/2/19

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