FORM 1023-EZ for BLACK LIVES MATTER 804

Field Data
EIN 85-2327295
Case Number EO-2020295-001134
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK LIVES MATTER 804
Organization’s Mailing Address 5009 BOBWHITE LANE
City RICHMOND
State VA
ZIP 23227
Accounting period End 12
Primary contact name CHLOE EDWARDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHLOE EDWARDS
PRESIDENT/DIRECTOR
9451 WEST BRIGHTWAY CIRCLE
HENRICO VA 23294

Officer/Director/Trustee Two

AMANDA LYNCH
VICE PRESIDENT/DIRECTOR
5009 BOBWHITE LANE
RICHMOND VA 23227

Officer/Director/Trustee Three

TINA CULBREATH
SECRETARY/DIRECTOR
PO BOX 4283
WINCHESTER VA 22604

Officer/Director/Trustee Four

EVAN TRUMAN
TREASURER/DIRECTOR
6421 KING LOUIS DRIVE
ALEXANDRIA VA 22312

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/30/2020
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R20 - Civil Rights, Advocacy for Specific Groups
Organization’s purpose Charitable: Yes
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 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 CHLOE EDWARDS
Signature Title PRESIDENT/DIRECTOR
Signature Date 10/15/2020

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