FORM 1023-EZ for BLACK TRANS NATION

Field Data
EIN 85-0778873
Case Number EO-2020114-000187
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK TRANS NATION
Organization’s Mailing Address 3403 FOSTER AVE APT 6G
City BROOKLYN
State NY
ZIP 11210
Accounting period End 1
Primary contact name KIYZIAH VAUGHN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIYZIAH VAUGHN
DIRECTOR
3403 FOSTER AVE APT 6G
BROOKLYN NY 11210

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/21/2020
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: No
Public Safety: Yes
Amateur Sports: Yes
Cruelty Prevention: Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KIYZIAH VAUGHN
Signature Title DIRECTOR
Signature Date 4/21/2020

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