FORM 1023-EZ for CINCY NATION BLACK

Field Data
EIN 84-5082981
Case Number EO-2020073-000339
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CINCY NATION BLACK
Organization’s Mailing Address 4382 EUROPEAN JAUNT
City WEST CHESTER
State OH
ZIP 45069
Accounting period End 12
Primary contact name KIRBY KEMPER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIRBY KEMPER
OFFICER
4382 EUROPEAN JAUNT
WEST CHESTER OH 45069

Officer/Director/Trustee Two

CHANTELLE MCGUIRE
DIRECTOR
3276 GREENWICH DRIVE
FAIRFIELD OH 45014

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/5/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N62 - Basketball
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 Yes
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 KIRBY KEMPER
Signature Title OFFICER
Signature Date 3/11/2020

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