FORM 1023-EZ for MISSION REBIRTH INC

Field Data
EIN 85-3204542
Case Number EO-2020304-000299
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISSION REBIRTH INC
Organization’s Mailing Address 3400 KENT AVE APT F201
City METAIRIE
State LA
ZIP 70006
Accounting period End 12
Primary contact name KANNEYA USSIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KANNEYA USSIN
PRESIDENT
3400 KENT AVE APT F201
METAIRIE LA 70006

Officer/Director/Trustee Two

KENDRICKE BROWN
SECRETARY
3400 KENT AVE APT F201
METAIRIE LA 70006

Officer/Director/Trustee Three

TERESA BROWN
TREASURER
3400 KENT AVE APT F201
METAIRIE LA 70006

Organization’s website
Organization’s email MISSIONREBIRTH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/25/2020
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 No
Correctness Declaration Yes
Signature Name KANNEYA USSIN
Signature Title PRESIDENT
Signature Date 10/28/2020

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