FORM 1023-EZ for BE A CHAMPION

Field Data
EIN 20-2763239
Case Number EO-2015016-000551
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BE A CHAMPION
Organization’s Mailing Address 1451 RUDY ROAD
City SPRING VALLEY
State CA
ZIP 91977-4141
Accounting period End 12
Primary contact name STEVEN HAYES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

STEVEN HAYES
EXECUTIVE DIRECTOR
PO BOX1264
LEMON GROVE CA 91946

Officer/Director/Trustee Two

RASHEED SALAAM
DEPUTY DIRECTOR
37007 MAGNOLIA STREET
NEWARK CA 94560

Officer/Director/Trustee Three

NANCY MONTGOMERY
PROGRAM DIRECTOR
1201 LONGRIDGE DRIVE
SAINT LOUIS MO 63137

Organization’s website WWW.BEACHAMPION.ORG
Organization’s email SCHAYES53@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/18/2003
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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