FORM 1023-EZ for SOUTH JERSEY BLACK HERITAGE MUSEUMA NEW JERSEY NON PROFIT CORPORATION

Field Data
EIN 43-3670738
Case Number EO-2018270-000590
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTH JERSEY BLACK HERITAGE MUSEUMA NEW JERSEY NON PROFIT CORPORATION
Organization’s Mailing Address 2010 NEW ALBANY RD
City CINNAMINSON
State NJ
ZIP 8077-3535
Accounting period End 12
Primary contact name ANITA JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH JACKSON
PRESIDENT
101 HENDRICKSON AVENUE
EDGEWATER PARK NJ 8010-2008

Officer/Director/Trustee Two

ANITA JACKSON
VICE PRESIDENT
101 HENDRICKSON AVENUE
EDGEWATER PARK NJ 8010-2008

Officer/Director/Trustee Three

JOANNA JACKSON
DIRECTOR OF COMMUNICATION
101 HENDRICKSON AVENUE
EDGEWATER PARK NJ 8010-2008

Officer/Director/Trustee Four

DONNA RODRIGUEZ
SECRETARY
2522 BEAUTYBERRY CIR E
JACKSONVILLE FL 32246-1349

Organization’s website HTTP://WWW.SJBHM.ORG
Organization’s email SJBHM2017@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/17/15
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ANITA JACKSON
Signature Title VICE PRESIDENT
Signature Date 9/25/18
EIN 43-3670738
Case Number EO-2018270-000590
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTH JERSEY BLACK HERITAGE MUSEUM A NEW JERSEY NON PROFIT CORPORATION
Organization’s Mailing Address 2010 NEW ALBANY RD
City CINNAMINSON
State NJ
ZIP 8077-3535
Accounting period End 12
Primary contact name ANITA JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH JACKSON
PRESIDENT
101 HENDRICKSON AVENUE
EDGEWATER PARK NJ 8010-2008

Officer/Director/Trustee Two

ANITA JACKSON
VICE PRESIDENT
101 HENDRICKSON AVENUE
EDGEWATER PARK NJ 8010-2008

Officer/Director/Trustee Three

JOANNA JACKSON
DIRECTOR OF COMMUNICATION
101 HENDRICKSON AVENUE
EDGEWATER PARK NJ 8010-2008

Officer/Director/Trustee Four

DONNA RODRIGUEZ
SECRETARY
2522 BEAUTYBERRY CIR E
JACKSONVILLE FL 32246-1349

Organization’s website HTTP://WWW.SJBHM.ORG
Organization’s email SJBHM2017@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/17/15
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ANITA JACKSON
Signature Title VICE PRESIDENT
Signature Date 9/25/18
EIN 43-3670738
Case Number EO-2016040-000308
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTH JERSEY BLACK HERITAGE MUSEUM-A NJ NON PROFIT CORPORATION
Organization’s Mailing Address 101 HENDRICKSON AVE
City EDGEWATER
State NJ
ZIP 08010
Accounting period End 12
Primary contact name ANITA JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANITA JACKSON
VICE PRESIDENT/TREASURER
101 HENDRICKSON AVE
EDGEWATER PARK NJ 08010

Officer/Director/Trustee Two

JOSEPH JACKSON
PRESIDENT
101 HENDRICKSON AVE
EDGEWATER PARK NJ 08010

Officer/Director/Trustee Three

DONNA RODIRQUEZ
SECRETARY
2022 BEAUTYBERRY COURT
JACKSONVILLE FL 32246

Officer/Director/Trustee Four

JOANNA JACKSON
DIRECTOR OF COMMUNICATION
101 HENDRICKSON AVE
EDGEWATER PARK NJ 08010

Organization’s website
Organization’s email AJACKSON1116@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/17/2015
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 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
Signature Title
Signature Date

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