FORM 1023-EZ for EMPOWERANCH

Field Data
EIN 82-2485216
Case Number EO-2017230-000112
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EMPOWERANCH
Organization’s Mailing Address 3425 N 14TH PL
City PHOENIX
State AZ
ZIP 85014-5151
Accounting period End 1
Primary contact name JESSICA VOSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA VOSS
DIRECTOR
3425 N 14TH PL
PHOENIX AZ 85014-5151

Officer/Director/Trustee Two

MONIQUE BONTRAGER
DIRECTOR
6401 S 37TH ST
PHOENIX AZ 85042-5003

Officer/Director/Trustee Three

LAURA JO BOYD
DIRECTOR
PO BOX 247
KEARNY AZ 85137-0105

Officer/Director/Trustee Four

FRANK VASQUEZ
DIRECTOR
11686 S M-43 HWY
DELTON MI 49046-9415

Officer/Director/Trustee Five

NICHOLAS KLAKULAK
DIRECTOR
7847 E TOPEKA PL
YUMA AZ 85365-8849

Organization’s website WWW.EMPOWERANCH.ORG
Organization’s email JESSIV@EMPOWERANCH.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/12/2017
Organization Incorporation State AZ
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: Yes
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 No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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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