FORM 1023-EZ for FUSION YOUTH CLUB INC

Field Data
EIN 83-2128755
Case Number EO-2019112-000613
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FUSION YOUTH CLUB INC
Organization’s Mailing Address 10926 QUALITY DR BOX 39065
City CHARLOTTE
State NC
ZIP 28278
Accounting period End 12
Primary contact name ERA DILLARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERA DILLARD
PRESIDENT
13026 PLANTERS ROW DR
CHARLOTTE NC 28278

Officer/Director/Trustee Two

SHERELLE FOSTER
SECRETARY
3746 CORBETT RD
CHARLOTTE NC 28278

Officer/Director/Trustee Three

KRIS PARKER
TREASURER
PO BOX 904
GRANITE QUARRY NC 28278

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/16/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building 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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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 ERA DILLARD
Signature Title PRESIDENT
Signature Date 4/19/19

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