FORM 1023-EZ for ELEVATED FOR SUCCESS INC

Field Data
EIN 84-4805340
Case Number EO-2020055-000767
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ELEVATED FOR SUCCESS INC
Organization’s Mailing Address 2400
City TRINITY
State FL
ZIP 34655
Accounting period End 12
Primary contact name MONICA HABERLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROLYN LONG
PRESIDENT
9545 MENDEL DR
NEW PORT RICHEY FL 34654

Officer/Director/Trustee Two

JAMIE CONSTANTINE
VICE PRESIDENT
10715 WATULA CT
NEW PORT RICHEY FL 34655

Officer/Director/Trustee Three

MONICA HABERLIN
SEC & TREASURER
12340 CRESTRIDGE LOOP
NEW PORT RICHEY FL 34655

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/15/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MONICA HABERLIN
Signature Title SEC & TREASURER
Signature Date 2/21/2020

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