FORM 1023-EZ for CLEARCHOICE COMMUNITY SERVICES INC

Field Data
EIN 47-1861636
Case Number EO-2014272-000189
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLEARCHOICE COMMUNITY SERVICES INC
Organization’s Mailing Address 4816 NICOLLET AVE S
City MINNEAPOLIS
State MN
ZIP 55419
Accounting period End 12
Primary contact name FLOYD GREEN JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MUZBAH RAZAK
PRESIDENT, DIRECTOR
4816 NICOLLET AVE S
MINNEAPOLIS MN 55419

Officer/Director/Trustee Two

ANISA MOHAMED
SECRETARY, DIRECTOR
704 E 134TH ST
BURNSVILLE MN 55337

Officer/Director/Trustee Three

SAADA RAZAK
TREASURER, DIRECTOR
13773 ASPEN GROVE LN
BURNSVILLE MN 55337

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/2/2014
Organization Incorporation State MN
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: 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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