FORM 1023-EZ for KELLIBREW SURVIVORS NETWORK
| Field | Data |
|---|---|
| EIN | 86-1364730 |
| Case Number | EO-2021065-000128 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | KELLIBREW SURVIVORS NETWORK |
| Organization’s Mailing Address | 630 FRANKLIN ST NE |
| City | WASHINGTON |
| State | DC |
| ZIP | 20017 |
| Accounting period End | 12 |
| Primary contact name | BRANDON WALLACE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SELVON WALDRON
CHAIRPERSON
2709 ARUNDEL ROAD 3
MOUNT RAINER MD 20712
Officer/Director/Trustee Two
BRANDON WALLACE
VICE CHAIRPERSON
617 MALCOLM X AVE SE
WAHINGTON DC 20032
Officer/Director/Trustee Three
WILLIAM KELLIBREW IV
TREASURER
5417 PEMBROKE AVE
BALTIMORE MD 21206
Officer/Director/Trustee Four
JURON MCMILLAN
SECRETARY
5417 PEMBROKE AVE
BALTIMORE MD 21206
Officer/Director/Trustee Five
DAWN HARRELL
DIRECTOR
650 SOUTH CHARLES STREET
BALTIMORE MD 21230
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/6/2020 |
| Organization Incorporation State | DC |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | R01 - 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 | Yes |
| Conducting Activities Outside of United States | Yes |
| 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 | SELVON WALDRON |
| Signature Title | CHAIRPERSON |
| Signature Date | 1/15/2021 |
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