FORM 1023-EZ for ONE5NINE

Field Data
EIN 82-5354980
Case Number EO-2018344-000357
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ONE5NINE
Organization’s Mailing Address 4225 MCDOWELL ROAD
City PHOENIX
State AZ
ZIP 85008
Accounting period End 12
Primary contact name THOMAS WROBEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSHUA HENRY
PRESIDENT
4225 E MCDOWELL ROAD
PHOENIX AZ 85008

Officer/Director/Trustee Two

JUAN GALLEGOS
DIRECTOR OF STUDENT ACTIVITIES
2618 W GABY ROAD
PHOENIX AZ 85041

Officer/Director/Trustee Three

ANTHONY LEAL
BOARD MEMBER
3127 W ST CATHERINE AVENUE
PHOENIX AZ 85041

Officer/Director/Trustee Four

DENISE WALKER
BOARD MEMBER
1802 W MARYLAND AVENUE APT 3110
PHOENIX AZ 85015

Officer/Director/Trustee Five

NICHOLA HENRY
SECRETARY/CHIEF ADMINISTRATIVE OFF
4225 E MCDOWELL ROAD
PHOENIX AZ 85008

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/5/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
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 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 JOSHUA HENRY
Signature Title PRESIDENT
Signature Date 12/7/18

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