FORM 1023-EZ for PHI BETA SIGMA FRATERNITY INC ALPHAEPSILON SIGMA CHAPTER

Field Data
EIN 46-5695212
Case Number EO-2015159-000416
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PHI BETA SIGMA FRATERNITY INC ALPHAEPSILON SIGMA CHAPTER
Organization’s Mailing Address PO BOX 1957
City PHOENIX
State AZ
ZIP 85001
Accounting period End 12
Primary contact name KYLE MARTIN-PETTIES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANTHONY HASKINS
PRESIDENT
12525 W WINSLOW AVE
AVONDALE AZ 85323

Officer/Director/Trustee Two

KENGATTA CALLEN
FIRST VICE PRESIDENT
1536 W APOLLO RD
PHOENIX AZ 85041

Officer/Director/Trustee Three

LONNIE WALL
SECOND VICE PRESIDENT
6118 N 12TH WAY
PHOENIX AZ 85014

Officer/Director/Trustee Four

KYLE MARTIN-PETTIES
TREASURER
2 SOUTH 194TH LANE
BUCKEYE AZ 85326

Officer/Director/Trustee Five

JASON BROWN
SECRETARY
3933 W DAHLIA DR
PHOENIX AZ 85029

Organization’s website WWW.PBS1914.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/31/1920
Organization Incorporation State DC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C03 - Professional Societies, Associations
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 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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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