FORM 1023-EZ for ACHIEVE ARTS ACADEMY INCORPORATED

Field Data
EIN 30-1099027
Case Number EO-2019184-000100
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ACHIEVE ARTS ACADEMY INCORPORATED
Organization’s Mailing Address 5751 STONE MILL DRIVE SUITE 1
City WINSTON SALEM
State NC
ZIP 27105-1227
Accounting period End 12
Primary contact name WIL MITCHELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WIL MITCHELL
PRESIDENT
5751 STONE MILL DRIVE SUITE 1
WINSTON SALEM NC 27105-1227

Officer/Director/Trustee Two

TANESHA HAMILTON
TREASURER
2020 MORGAN CIRCLE
WINSTON SALEM NC 27127-5091

Officer/Director/Trustee Three

VALDERIA RAYNOR
SECRETARY
1100 NORTH JACKSON AVENUE
WINSTON SALEM NC 27101-1734

Officer/Director/Trustee Four

OSCEOLA THOMAS
BOARD MEMBER
9735 BAXTER CALDWELL DRIVE
CHARLOTTE NC 28213-4274

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/18
Organization Incorporation State NC
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 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 OSCEOLA THOMAS
Signature Title BOARD MEMBER
Signature Date 7/1/19

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