FORM 1023-EZ for UZIMA NATIONAL YOUTH MENTORING SERVICES CORP

Field Data
EIN 85-3195664
Case Number EO-2020281-000084
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name UZIMA NATIONAL YOUTH MENTORING SERVICES CORP
Organization’s Mailing Address 3939 LAVISTA ROAD STE 403
City TUCKER
State GA
ZIP 30084
Accounting period End 12
Primary contact name PATRICE ROBERTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICE ROBERTS
EXECUTIVE DIRECTOR
694 POST ROAD ROAD
STONE MOUNTAIN GA 30088

Officer/Director/Trustee Two

TIM SANFORD
DIRECTOR
2214 CRYSTAL LAKE DR
LAWRENCEVILLE GA 30044

Officer/Director/Trustee Three

CHRIS COLSTON
BOARD DIRECTOR
2216 WORALL HILL DRIVE
DULUTH GA 30096

Officer/Director/Trustee Four

VONSHURII WRIGHTEN
BOARD DIRECTOR
5729 TAFFETA COURT
LITHONIA GA 30058

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/2020
Organization Incorporation State GA
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: 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 PATRICE ROBERTS
Signature Title EXECUTIVE DIRECTOR
Signature Date 10/5/2020

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