FORM 1023-EZ for YOUR NEIGHBORHOOD CLINIC

Field Data
EIN 47-1633625
Case Number EO-2016210-000102
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name YOUR NEIGHBORHOOD CLINIC
Organization’s Mailing Address 2007 VERMONT AVE
City WASHINGTON
State DC
ZIP 20001
Accounting period End 8
Primary contact name SHAREEFAH ALUQDAH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAREEFAH ALUQDAH
EXECUTIVE DIRECTOR
5205 BLAINE ST NE
WASHINGTON DC 20019

Officer/Director/Trustee Two

MINISHA HICKS
BOARD TREASURER
2317 16TH ST APT 102
WASHINGTON DC 20020

Officer/Director/Trustee Three

HAZEL OGUGA
BOARD SECERTARY
725 32ND ST SE
WASHINGTON DC 20019

Organization’s website WWW.YOURNEIGHBORHOODCLINIC.ORG
Organization’s email ABOUT@YOURNEIGHBORHOODCLINIC.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/10/2014
Organization Incorporation State DC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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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