FORM 1023-EZ for SURVIVORS EMPOWERED INC

Field Data
EIN 82-2700791
Case Number EO-2017251-000431
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SURVIVORS EMPOWERED INC
Organization’s Mailing Address RIVERTON WHARF
City RIVERTON
State MD
ZIP 21837-2204
Accounting period End 6
Primary contact name MICHAEL PRETL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL OATS
DIRECTOR
1100 WASHINGTON AVE
MIAMI FL 33139

Officer/Director/Trustee Two

CHRISTIAN HEYNE
DIRECTOR
805 15TH ST NW
WASHINGTON DC 20005

Officer/Director/Trustee Three

PAMELA BOSLEY
DIRECTOR
1210 WEST 78 PLACE
CHICAGO IL 60620

Officer/Director/Trustee Four

MICHAEL PRETL
DIRECTOR/COUNSEL
RIVERTON WHARF
RIVERTON MD 21837-2204

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/31/2017
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
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 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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