FORM 1023-EZ for KAPY BASH FOUNDATION

Field Data
EIN 47-2501096
Case Number EO-2017278-000372
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KAPY BASH FOUNDATION
Organization’s Mailing Address KAPINGA BASHALA
City WHITEHALL
State PA
ZIP 18052
Accounting period End 12
Primary contact name KAPINGA BASHALA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAPINGA BASHALA
DIRECTOR/ PRESIDENT
5108 SAYLOR PARK DR APT 7
WHITEHALL PA 18052

Officer/Director/Trustee Two

DR LUC KAMANGA
HEALTHCARE MANAGEMENT
5108 SAYLOR PARK DR APT 7
WHITEHALL PA 18052

Officer/Director/Trustee Three

JESSY PEAN EBONZO
EXECUTIVE SECRETARY
2 BENNINGTON CT
EASTON PA 18040

Officer/Director/Trustee Four

LAURA LUMBAYI
CHIEF OPERATING OFFICER
10 JORDAN DR APT 9
WHITEHALL PA 18040

Officer/Director/Trustee Five

BLANDINE MBALA-FONKEU
COORDINATOR/ FAMILY PLANNING
1730 WAGON WEEL DR
EASTON PA 18040

Organization’s website
Organization’s email KAPYBASHMODE@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/25/2014
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G99 - Diseases, Disorders, Medical Disciplines N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 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 Yes
One Third Support Gifts No
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
EIN 47-2501096
Case Number EO-2015002-000105
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KAPY BASH FOR MOTHERS AND CHILDREN
Organization’s Mailing Address 402 SOUTH OAK ST
City BETHLEHEM
State PA
ZIP 18017
Accounting period End 12
Primary contact name KAPINGA BASHALA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAPINGA BASHALA
PRESIDENT DIRECTOR OF FINANCIAL
402 SOUTH OAK ST
BETHLEHEM PA 18017

Officer/Director/Trustee Two

DR LUC KAMANGA
VICE PRESIDENT
402 SOUTH OAK ST
BETHLEHEM PA 18017

Officer/Director/Trustee Three

JESSY EBONZO
EXECUTIVE SECRETARY
BENNINGTON CT
EASTON PA 18040

Officer/Director/Trustee Four

SLYVA GRACIA LUMBAYI
PSYCHOLOGIST ADVISOR
402 SOUTH OAK ST
BETHLEHEM PA 18017

Officer/Director/Trustee Five

GEORGINE MAYILA KOUSSOU
DIRECTOR OF FAMILY PLANNING
1725 SEQUOIA CT
ALLENTOWN PA 18104

Organization’s website
Organization’s email KAPYBASHMODE@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/25/2014
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative 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 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 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
Signature Title
Signature Date

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