FORM 1023-EZ for MUSLIM YOUTH FOR POSITIVE IMPACT

Field Data
EIN 83-0998674
Case Number EO-2019107-000096
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MUSLIM YOUTH FOR POSITIVE IMPACT
Organization’s Mailing Address 1880 GOLDEN EAGLE CT
City BROOMFIELD
State CO
ZIP 80020-1274
Accounting period End 12
Primary contact name HUMA EBADI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HUMA EBADI
EXECUTIVE DIRECTOR
1880 GOLDEN EAGLE CT
BROOMFIELD CO 80020-1274

Officer/Director/Trustee Two

YUSRA SHAIKH
PRESIDENT
9357 GARFIELD WAY
THORNTON CO 80229-4272

Officer/Director/Trustee Three

AISHA MOHAMED-ZULLALI
VICE-PRESIDENT
1058 E 96TH PL
THORONTON CO 80229-7828

Officer/Director/Trustee Four

SARA RUSTA
TREASURER
440 WEST 114TH PLACE
NORTHGLENN CO 80234-3065

Officer/Director/Trustee Five

AMINA HASHEM
SECRETARY
1300 30TH ST A1-14
BOULDER CO 80303-1729

Organization’s website WWW.MYPI-COLORADO.ORG
Organization’s email MYPICOLORADO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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 HUMA EBADI
Signature Title EXECUTIVE DIRECTOR
Signature Date 4/15/19

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