FORM 1023-EZ for LOCAL PASS BOOK YOUTH MEDIA

Field Data
EIN 47-2096536
Case Number EO-2015173-000332
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LOCAL PASS BOOK YOUTH MEDIA
Organization’s Mailing Address 1824 DOMINION WAY
City COLORADO SPRINGS
State CO
ZIP 80918
Accounting period End 12
Primary contact name DIANA K SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DIANA SMITH
EXECUTIVE DIRECTOR
1824 DOMINION WAY
COLORADO SPRINGS CO 80918

Officer/Director/Trustee Two

ANNE HYPOLITE
PRESIDENT
3278 FOXRIDGE DRIVE
COLORADO SPRINGS CO 80916

Officer/Director/Trustee Three

KAREN WHITE
TREASURER/SECRETARY
688 BOSQUE VISTA POINT
COLORADO SPRINGS CO 80916

Organization’s website WWW.LOCALPASSBOOKYOUTHMEDIA.COM
Organization’s email INFO@LOCALPASSBOOKYOUTHMEDIA.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/16/2014
Organization Incorporation State CO
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: 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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