FORM 1023-EZ for CONGREGATION AHAVATH SHOLOM MENS CLUB

Field Data
EIN 11-3663020
Case Number EO-2015264-000433
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CONGREGATION AHAVATH SHOLOM MENS CLUB
Organization’s Mailing Address 4050 SOUTH HULEN
City FT. WORTH
State TX
ZIP 76109
Accounting period End 12
Primary contact name MARVIN BELECK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KALMAN SILVERBERG
PRESIDENT
4212 INMAN COURT
FT. WORTH TX 76109

Officer/Director/Trustee Two

FOSTER OWEN
1ST VICE PRESIDENT
4808 BARKRIDGE TRAIL
FT. WORTH TX 76109

Officer/Director/Trustee Three

BEN HERMAN
SECRETARY
4701SPRINGWILLOW ROAD
FT. WORTH TX 76109

Officer/Director/Trustee Four

EBRAHIM LAVI
DIRECTOR
7824 PIRATE POINT CIRCLE
ARLINGTON TX 76016

Officer/Director/Trustee Five

MARVIN BELECK
TREASURER
4304 WEDTDALE DRIVE
FT. WORTH TX 76109-4913

Organization’s website WWW.AHAVATHSHOLOM.ORG
Organization’s email MARVINBELECK@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/22/2002
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X30 - Jewish
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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