FORM 1023-EZ for DERTY BEGINNINGS YOUTH MENTORING PROGRAM

Field Data
EIN 86-2306040
Case Number EO-2021093-000120
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DERTY BEGINNINGS YOUTH MENTORING PROGRAM
Organization’s Mailing Address 1369 SEARLE STREET
City SAINT PAUL
State MN
ZIP 55130
Accounting period End 12
Primary contact name CHRIS CRUTCHFIELD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUSSEL BALENGER
PRESIDENT
817 DAYTON AVENUE
SAINT PAUL MN 55104

Officer/Director/Trustee Two

ANTONIO NADEAU
VICE PRESIDENT
931 KENNARD STREET
SAINT PAUL MN 55106

Officer/Director/Trustee Three

MARCIA TYNER
SECRETARY
1533 WOODBRIDGE STREET APT 108
SAINT PAUL MN 55117

Officer/Director/Trustee Four

JUANITA FORD
TREASURER
1275 HAZELWOOD STREET APT 203
SAINT PAUL MN 55106

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/2021
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
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 RUSSEL BALENGER
Signature Title PRESIDENT
Signature Date 3/1/2021

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