FORM 1023-EZ for CHAMP COMMUNITY HANDS IN ACTION MENTORING PROGRAM INC

Field Data
EIN 47-1036654
Case Number EO-2016197-000312
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHAMP COMMUNITY HANDS IN ACTION MENTORING PROGRAM INC
Organization’s Mailing Address 66 HARRIET STREET
City BRIDGEPORT
State CT
ZIP 06608
Accounting period End 5
Primary contact name REUEL PARKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REUEL PARKS
PRESIDENT
123 KAYE VUE DRIVE
HAMDEN CT 06514

Officer/Director/Trustee Two

MARCUS STOVALL
VICE PRESIDENT
495 HILL STREET
HAMDEN CT 06518

Officer/Director/Trustee Three

MAGUENA D-ADETONA
TREASURER
55 WESSELS AVENUE
BRIDGEPORT CT 06610

Organization’s website
Organization’s email CHAMPMENTORINGPROGRAM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/2014
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 Yes
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 Yes
One Third Support Gifts No
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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