FORM 1023-EZ for BASIS IMPACT GROUP FOUNDATION INC

Field Data
EIN 81-5262949
Case Number EO-2018018-000321
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BASIS IMPACT GROUP FOUNDATION INC
Organization’s Mailing Address 75 BROAD STREET SUITE 2110
City NEW YORK
State NY
ZIP 10004
Accounting period End 12
Primary contact name PATRICK I LUCAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIRK SYKES
PRESIDENT AND CHAIRMAN
75 STATE STREET SUITE 1410
BOSTON MA 2109

Officer/Director/Trustee Two

TAMMY JONES
VICE PRESIDENT AND CO CHARIMAN
75 BROAD STREET SUITE 2110
NEW YORK NY 10004

Officer/Director/Trustee Three

CHLOE BARZEY
SECRETARY AND DIRECTOR
75 FIFTH STREET NW SUITE 1100
ATLANTA GA 30308

Officer/Director/Trustee Four

ALBERT LUCAS
TREASURER AND DIRECTOR
5 PENN PLAZA 15TH FLOOR
NEW YORK NY 10001

Officer/Director/Trustee Five

PATRICK LUCAS
DIRECTOR AND CO-SECRETARY
1600 PARKWOOD CIRCLE SUITE 200
ATLANTA GA 30339

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/17
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PATRICK LUCAS
Signature Title DIRECTOR AND CO-SECRETARY
Signature Date 1/16/18

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