FORM 1023-EZ for BLACKMEN LIFE INSURANCE FOUNDATION

Field Data
EIN 38-4137069
Case Number EO-2020160-000490
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACKMEN LIFE INSURANCE FOUNDATION
Organization’s Mailing Address 1972 QUEBEC AVENUE
City SAN LEANDRO
State CA
ZIP 94579
Accounting period End 12
Primary contact name MARTIN L SHARP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARTIN SHARP
FOUNDER & CEO
1972 QUEBEC AVENUE
SAN LEANDRO CA 94579

Organization’s website WWW.BLACKMENLIFE.ORG
Organization’s email MARTINLSHARP@BLACKLIFE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2019
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 Yes
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 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 MARTIN SHARP
Signature Title FOUNDER & CEO
Signature Date 6/5/2020

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