FORM 1023-EZ for BLACK HEALTH

Field Data
EIN 84-2643023
Case Number EO-2019221-000166
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK HEALTH
Organization’s Mailing Address 2300 KATHRYN LN APT 3326
City PLANO
State TX
ZIP 75025
Accounting period End 12
Primary contact name BILLI PIPES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BILLI PIPES
PRESIDENT &F FOUNDER
2300 KATHRYN LN APT 3326
PLANO TX 75025

Officer/Director/Trustee Two

TY SMITH
TREASURER & SECRETARY
1730 ELIZABETH DR
CARROLTON TX 75007

Organization’s website WWW.LOVEBLACKHEALTH.COM
Organization’s email LOVEBLACKHEALTH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 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 BILLI PIPES
Signature Title PRESIDENT &F FOUNDER
Signature Date 8/7/19

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