FORM 1023-EZ for TRIPLE 5 TEENS

Field Data
EIN 81-2617384
Case Number EO-2016252-000303
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TRIPLE 5 TEENS
Organization’s Mailing Address 2112 W MERGANSER
City NORTH LAS VEGAS
State NV
ZIP 89084
Accounting period End 6
Primary contact name VICTORIA BOYD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANNE BROWN
PRESIDENT
2112 W MERGANSER
NORTH LAS VEGAS NV 89084

Officer/Director/Trustee Two

STAN CHAN
SECRETARY
5575 SIMMONS ST UNIT 1 118
NORTH LAS VEGAS NV 89031

Officer/Director/Trustee Three

KRISTINA CHILDS
TREASURER
3305 E ROME 2071
NORTH LAS VEGAS NV 89032

Officer/Director/Trustee Four

JESSICA BROWN
DIRECTOR
4941 DULCE NORTE
NORTH LAS VEGAS NV 89031

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/13/2016
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development 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 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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