FORM 1023-EZ for VIRGINIA BLACK HISTORY MONTH ASSOCIATION

Field Data
EIN 26-3986256
Case Number EO-2015005-000180
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VIRGINIA BLACK HISTORY MONTH ASSOCIATION
Organization’s Mailing Address 4121 PLANK ROAD - BOX 213
City FREDERICKSBURG
State VA
ZIP 22407-4888
Accounting period End 6
Primary contact name WILLIAM JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM JONES
PRESIDENT
11012 CANVASBACK CT
SPOTSYLVANIA VA 22553-3654

Officer/Director/Trustee Two

GERRY GRIFFIN
VICE-PRESIDENT
PO BOX 642
QUANTICO VA 22134-0642

Officer/Director/Trustee Three

ROBERT HALL
CHIEF OF STAFF
4121 PLANK ROAD BOX 213
FREDERICKSBURG VA 22407-4888

Officer/Director/Trustee Four

JONATHAN NEWELL
DIRECTOR
4121 PLANK ROAD BOX 213
FREDERICKSBURG VA 22407-4888

Officer/Director/Trustee Five

DEBRA GRAHAM
SECRETARY
4121 PLANK ROAD BOX 213
FREDRICKSBURG VA 22407-4888

Organization’s website WWW.VABHMA.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/2009
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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