FORM 1023-EZ for DELTA EMPOWERMENT INITIATIVE

Field Data
EIN 81-2864379
Case Number EO-2020267-000179
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DELTA EMPOWERMENT INITIATIVE
Organization’s Mailing Address 12 COUNTY ROAD 779
City WYNNE
State AR
ZIP 72396
Accounting period End 12
Primary contact name BEVERLY NEWBORN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BEVERLY NEWBORN
CHAIRMAN
1045 RIO GRANDE ROAD
CONWAY AR 72034

Officer/Director/Trustee Two

STEPHANIE INGRAHAM
TREASURER
2575 GLADIOLA
CONWAY AR 72034

Officer/Director/Trustee Three

TAMARA BRAND
SECRETARY
12 COUNTY ROAD 779
WYNNE AR 72396

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/3/2016
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BEVERLY NEWBORN
Signature Title CHAIRMAN
Signature Date 9/18/2020
EIN 81-2864379
Case Number EO-2016344-000210
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DELTA EMPOWERMENT INITIATIVE INC
Organization’s Mailing Address 944 WASHINGTON
City FORREST CITY
State AR
ZIP 72335
Accounting period End 12
Primary contact name BEVERLY NEWBORN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BEVERLY NEWBORN
CHAIRMAN
944 NORTH WASHINGTON AVENUE
FORREST CITY AR 72335

Officer/Director/Trustee Two

MARY SCOTT
TREASURER
P O BOX 164473
LITTLE ROCK AR 72216

Officer/Director/Trustee Three

YOLANDA DAWSON
SECRETARY
12 COUNTY ROAD 779
WYNNE AR 71496

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/3/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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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