FORM 1023-EZ for COMMUNITY LIVING ASSISTANCE SUPPORTSERVICES INC

Field Data
EIN 47-4804250
Case Number EO-2015231-000256
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY LIVING ASSISTANCE SUPPORTSERVICES INC
Organization’s Mailing Address 4607 E 144TH ST
City CLEVELAND
State OH
ZIP 44128
Accounting period End 12
Primary contact name LALESA JONES-DOLLAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LALESA JONES-DOLLAR
PRESIDENT
4607 E 144TH ST
CLEVELAND OH 44128

Officer/Director/Trustee Two

RAMASCUS DOLLAR
VICE-PRESIDENT
4607 E 144TH ST
CLEVELAND OH 44128

Officer/Director/Trustee Three

PAMELA SCOTT
BOARD MEMBER
3549 CHELTON RD
SHAKER HEIGHTS OH 44120

Officer/Director/Trustee Four

TAWNYA PRIMOUSSMITH
BOARD MEMBER
3598 MENLO RD
SHAKER HEIGHTS OH 44120

Officer/Director/Trustee Five

ETHAN GLINSEY
BOARD MEMBER
4771 COUNTRY LN APT D24
WARRENSVILLE HEIGHTS OH 44128

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/2013
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 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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