FORM 1023-EZ for ANSARDINE-USA INC

Field Data
EIN 84-3176571
Case Number EO-2021172-000023
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANSARDINE-USA INC
Organization’s Mailing Address 2514 SOUTH CARROLL STREET
City PHILADELPHIA
State PA
ZIP 19142
Accounting period End 12
Primary contact name SOUMAILA FANE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SOUMAILA FANE
PRESIDENT
2514 SOUTH CARROLL STREET
PHILADELPHIA PA 19142

Officer/Director/Trustee Two

YOUSSOUF SYLLA
VICE PRESIDENT
2514 SOUTH CARROLL STREET
PHILADELPHIA PA 19142

Officer/Director/Trustee Three

KARIM COULIBALY
TREASURER
2514 SOUTH CARROLL STREET
PHILADELPHIA PA 19142

Officer/Director/Trustee Four

ABDOUL KOITA
SECRETARY
2514 SOUTH CARROLL STREET
PHILADELPHIA PA 19142

Officer/Director/Trustee Five

NANA MARIKO
OFFICER
2514 SOUTH CARROLL STREET
PHILADELPHIA PA 19142

Organization’s website
Organization’s email FANE3US@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/2019
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 SOUMAILA FANE
Signature Title PRESIDENT
Signature Date 6/16/2021

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