FORM 1023-EZ for UNIVERSAL SMILES

Field Data
EIN 84-2538674
Case Number EO-2019238-000250
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name UNIVERSAL SMILES
Organization’s Mailing Address 3419 HOLT STREET
City CHARLOTTE
State NC
ZIP 28205
Accounting period End 11
Primary contact name MARC WEBER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARC WEBER
EXECUTIVE DIRECTOR
1301 RHODE ISLAND AVE NW APT 1
WASHINGTON DC 20005

Officer/Director/Trustee Two

MICHAEL FARMER
CHAIR
3419 HOLT STREET
CHARLOTTE NC 28205

Officer/Director/Trustee Three

DANIEL HOSTRANDER
TREASURER
1700 CAMDEN ROAD
CHARLOTTE NC 28203

Officer/Director/Trustee Four

KATIE PAYNE
SECRETARY
100 STRATFORD LAKES DRIVE UNIT 119
DURHAM NC 27713

Officer/Director/Trustee Five

CHRIS GOTTFRIED
BOARD MEMBER
4108 CHERRYLAUREL LANE
WINSTON-SALEM NC 27106

Organization’s website WWW.FACEBOOK.COM/UNCUGANDAPROJECT/
Organization’s email MEWEBERJR@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/8/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
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 MARC WEBER
Signature Title EXECUTIVE DIRECTOR
Signature Date 8/22/19

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