FORM 1023-EZ for CAPTURE DEVELOPMENTAL AND COMMUNITYSERVICES INC

Field Data
EIN 85-0900332
Case Number EO-2020125-000522
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAPTURE DEVELOPMENTAL AND COMMUNITYSERVICES INC
Organization’s Mailing Address 1519 N 35TH STREET
City OMAHA
State NE
ZIP 68111
Accounting period End 12
Primary contact name ANTONIA DORSEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTONIA DORSEY
PRESIDENT/DIRECTOR
2615 N 32ND STREET
OMAHA NE 68111

Officer/Director/Trustee Two

ANTIANA VALENTINE
SECRETARY/DIRECTOR
1903 LAIRD STREET
OMAHA NE 68110

Officer/Director/Trustee Three

JAMAR DORSEY
TREASURER/DIRECTOR
2615 N 32ND STREET
OMAHA NE 68111

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/2020
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, 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 No
Donation of funds Yes
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 ANTONIA DORSEY
Signature Title PRESIDENT/DIRECTOR
Signature Date 5/1/2020

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