FORM 1023-EZ for SONOMA COUNTY BLACK FORUM

Field Data
EIN 38-4070204
Case Number EO-2018101-000523
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SONOMA COUNTY BLACK FORUM
Organization’s Mailing Address P O BOX 1093
City SANTA ROSA
State CA
ZIP 95402-1093
Accounting period End 12
Primary contact name REGINA BRENNAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SEGRETTA WOODARD
CHAIR
PO BOX 1092
WINDSOR CA 95492-1092

Officer/Director/Trustee Two

NANCY ROGERS
TREASURER
2743 MOHAWK ST
SANTA ROSA CA 95403-3220

Officer/Director/Trustee Three

REGINA BRENNAN
SECRETARY
2879 OLD GRAVENSTEIN HWY
SEBASTOPOL CA 95472-5209

Officer/Director/Trustee Four

NZINGA WOODS
SECRETARY
1941 CITRINE WAY
SANTA ROSA CA 95404-7012

Officer/Director/Trustee Five

FAITH ROSS
BOARD MEMBER
500 KUCK LANE
PETALUMA

Organization’s website
Organization’s email SONOMACOUNTYBLACKFORUM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/13/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 REGINA BRENNAN
Signature Title SECRETARY
Signature Date 4/9/18

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