FORM 1023-EZ for SANKOFA SUPPORTIVE PROGRAM SERVICESINC

Field Data
EIN 47-1913085
Case Number EO-2015226-000199
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SANKOFA SUPPORTIVE PROGRAM SERVICESINC
Organization’s Mailing Address 255 ORANGE STREET
City ALBANY
State NY
ZIP 12210
Accounting period End 12
Primary contact name ANGELA LEWIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANGELA LEWIN
PRESIDENT AND BOARD MEMBER
44 NORTH ALLEN STREET
ALBANY NY 12203

Officer/Director/Trustee Two

DONALD FERNANDEZ
TREASURER AND BOARD MEMBER
23 LAKESHORE DRIVE APT C
WATERVLIET NY 12189

Officer/Director/Trustee Three

REGINA LOVE
TREASURER AND BOARD MEMBER
143 SOUTHERN BOULEVARD
ALBANY NY 12209

Officer/Director/Trustee Four

LISA MCKEEN
SECRETARY AND BOARD MEMBER
PO BOX 152
EAST SCHODACK NY 12063

Officer/Director/Trustee Five

GINA MASCALI
BOARD MEMBER
20 DUTCH VILLAGE 4C
MENANDS NY 12204

Organization’s website NONE
Organization’s email ALEWIN@ALBANYBEHAVIORALHEALTHLLC.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/2014
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J02 - Management & Technical Assistance
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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