FORM 1023-EZ for NUBIAN SISTERS CANCER SUPPORT GROUP

Field Data
EIN 43-1998856
Case Number EO-2015295-000461
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NUBIAN SISTERS CANCER SUPPORT GROUP
Organization’s Mailing Address 298 SUMMIT ST
City NEW HAVEN
State CT
ZIP 06513
Accounting period End 6
Primary contact name JACQUELINE ROBERTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JACQUELINE ROBERTS
EXECUTIVE DIRECTOR
298 SUMMIT ST
NEW HAVEN CT 06513

Officer/Director/Trustee Two

OLIVIA HENDERSON
TREASURER
247 HIGHLAND ST
NEW HAVEN CT 06519

Officer/Director/Trustee Three

JANIQUA ROBERTS
SECRETARY
298 SUMMIT ST
NEW HAVE CT 06513

Organization’s website
Organization’s email NUBIANSISTERSCSG@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/21/2004
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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