FORM 1023-EZ for VILLAGE ACTIVATE

Field Data
EIN 87-1704045
Case Number EO-2021201-000161
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VILLAGE ACTIVATE
Organization’s Mailing Address 4007 SOUTHERN PARKWAY SUITE 1
City LOUISVILLE
State KY
ZIP 40214
Accounting period End 12
Primary contact name 3
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROMANETHA STALLWORTH
DIRECTOR
4007 SOUTHERN PWKY SUITE 1
LOUISVILLE KY 40214

Officer/Director/Trustee Two

AUNDRA LIPSCOMB
DIRECTOR
4007 SOUTHERN PWKY SUITE 1
LOUISVILLE KY 40214

Officer/Director/Trustee Three

HATTIE MINTER
DIRECTOR
4007 SOUTHERN PWKY SUITE 1
LOUISVILLE KY 40214

Officer/Director/Trustee Four

DONYA BELL
DIRECTOR
4007 SOUTHERN PWKY SUITE 1
LOUISVILLE KY 40214

Organization’s website UNDER CONSTRUCTION
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/15/2021
Organization Incorporation State KY
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: 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 AUNDRA LIPSCOMB
Signature Title DIRECTOR
Signature Date 7/18/2021

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