FORM 1023-EZ for EMPOWER YOUTH

Field Data
EIN 47-3301431
Case Number EO-2015065-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EMPOWER YOUTH
Organization’s Mailing Address 4241 WIGEON PLACE
City BATAVIA
State OH
ZIP 45103
Accounting period End 12
Primary contact name LORI CONLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LORI CONLEY
DIRECTOR
4241 WIGEON PLACE
BATAVIA OH 45103

Officer/Director/Trustee Two

KATHLEEN MILLER
TREASURER
PO BOX 35
HAMMERSVILLE OH 45130

Officer/Director/Trustee Three

BARBARA TURNER
SECRETARY
3522 INEZ AVE
BETHEL OH 45106

Officer/Director/Trustee Four

KRISTAN COVER
PRESIDENT
443 N WATER STREET
GEORGETOWN OH 45121

Organization’s website
Organization’s email TOEMPOWERYOUTH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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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