FORM 1023-EZ for BLACK GIRLS SMILE INC

Field Data
EIN 45-5352968
Case Number EO-2016216-000139
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLACK GIRLS SMILE INC
Organization’s Mailing Address 755 NORTH AVENUE NE UNIT 2204
City ATLANTA
State GA
ZIP 30306
Accounting period End 12
Primary contact name LAUREN CARSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAUREN CARSON
EXECUTIVE DIRECTOR
755 NORTH AVENUE NE UNIT 2204
ATLANTA GA 30306

Officer/Director/Trustee Two

JADE HALL
FOUNDING BOARD MEMBER
601 MACDONOUGH STREET
BROOKLYN NY 11233

Officer/Director/Trustee Three

DANIELLE CADET
FOUNDING BOARD MEMBER
345 MONTGOMERY STREET
BROOKLYN NY 11225

Organization’s website WWW.BLACKGIRLSSMILE.ORG
Organization’s email CONTACT@BLACKGIRLSSMILE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/2012
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F01 - Alliance/Advocacy Organizations
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 No
One Third Support Gifts Yes
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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