FORM 1023-EZ for BLACK INDIVIDUAL INITIATIVE OF AMERICA

Field Data
EIN 83-4562610
Case Number EO-2020309-000053
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK INDIVIDUAL INITIATIVE OF AMERICA
Organization’s Mailing Address 21044 SHERMAN WAY 231
City CANOGA PARK
State CA
ZIP 91303
Accounting period End 12
Primary contact name XAVIER MITCHELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

XAVIER MITCHELL
PRESIDENT
3010 WILSHIRE BLVD 304
LOS ANGELES CA 90010

Officer/Director/Trustee Two

DANA BELL
SECRETARY
3010 WILSHIRE BLVD 304
LOS ANGELES CA 90010

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/11/2019
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 XAVIER MITCHELL
Signature Title PRESIDENT
Signature Date 11/2/2020

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