FORM 1023-EZ for BALOUK WASHINGTON USA

Field Data
EIN 32-0490528
Case Number EO-2017193-000394
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BALOUK WASHINGTON USA
Organization’s Mailing Address 667 TIVOLI ROAD
City FREDERICK
State MD
ZIP 21703
Accounting period End 12
Primary contact name VINCENT TCHOUAFFE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VINCENT TCHOUAFFE
TREASURER
667 TIVOLI ROAD
FREDERICK MD 21703

Officer/Director/Trustee Two

JEAN JULES KAKANOU
PRESIDENT
14760 MCKNEW RD
BURTONSVILLE MD 20866

Officer/Director/Trustee Three

FABIEN NGUEKAM
CHAIRMAN
1818 METZEROT RD APT 51
HYATTSVILLE MD 20783

Officer/Director/Trustee Four

GUY BERTIN LEUMALIEU
SECRETARY
18359 LOST KNIFE CIRCLE APT 103
MONTGOMERY VILLAGE MD 20886

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/11/2016
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 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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