FORM 1023-EZ for KIBERA PRIDE USA

Field Data
EIN 82-1518760
Case Number EO-2020258-000499
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KIBERA PRIDE USA
Organization’s Mailing Address 113 WEST MAIN STREET
City KASON
State MN
ZIP 55944
Accounting period End 12
Primary contact name DANIEL BREVICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL BREVICK
PRESIDENT
113 WEST MAIN STREET
KASON MI 55944

Officer/Director/Trustee Two

AGNES NABUSAYI
TREASURER
113 WEST MAIN STREET
KASON MI 55944

Officer/Director/Trustee Three

SHEIKNOR QASSIM
SECRETARY
1816 BAIHLY HILLS DR SW
ROCHESTER NY 55902

Officer/Director/Trustee Four

NICK CHARLES
DIRECTOR
992 CUMBERLAND
BERKLEY MI 48072

Organization’s website
Organization’s email DUCKFEET13@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/14/2017
Organization Incorporation State MN
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 Yes
Conducting Activities Outside of United States Yes
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 DANIEL BREVICK
Signature Title PRESIDENT
Signature Date 9/11/2020

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