FORM 1023-EZ for BOYS TO MEN TRANSITIONAL HOME INC

Field Data
EIN 81-4014384
Case Number EO-2017317-000714
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BOYS TO MEN TRANSITIONAL HOME INC
Organization’s Mailing Address 8240 ELMWAY DR
City DAYTON
State OH
ZIP 45415
Accounting period End 12
Primary contact name MICHELLE GRUBBS PIPPINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM PIPPINS
VICE-PRESIDENT
8240 ELMWAY DR
DAYTON OH 45415

Officer/Director/Trustee Two

SHEILA SPEARS
TREASURER
923 RIVERVIEW TERRACE
DAYTON OH 45402

Officer/Director/Trustee Three

KARMEIKA MCINTOSH
SECRETARY
232 CENTERBURY CT
CINCINNATI OH 45246

Officer/Director/Trustee Four

JEMONE MCINTOSH
PRESIDENT
232 CENTERBURY CT
DAYTON OH 45415

Officer/Director/Trustee Five

MICHELLE GRUBBS PIPPINS
CEO
8240
DAYTON OH 45415

Organization’s website
Organization’s email GRUBBSMICHELLE@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/30/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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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