FORM 1023-EZ for STUDENT EMPOWERMENT PROGRAM INC

Field Data
EIN 47-5603087
Case Number EO-2015338-000057
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name STUDENT EMPOWERMENT PROGRAM INC
Organization’s Mailing Address 52 MEADOW RIDGE ROAD
City AVON
State CT
ZIP 06001
Accounting period End 12
Primary contact name JACOB MEDINA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JACOB MEDINA
PRESIDENT
52 MEADOW RIDGE ROAD
AVON CT 06001

Officer/Director/Trustee Two

SEAN GRIFFIN
TREASURER
36 VAN ZANDT ROAD
SKILLMAN NJ 08558

Officer/Director/Trustee Three

JAY TREBICKA
CLERK
40 CROSS STREET APT 16
QUINCY MA 02169

Organization’s website STUDENTEMPOWERMENTPROGRAM.ORG
Organization’s email JAKE.MEDINA@STUDENTEMPOWERMENTPROGRAM.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/13/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
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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