FORM 1023-EZ for AZUMAH NELSON FOUNDATION

Field Data
EIN 32-0348028
Case Number EO-2015117-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AZUMAH NELSON FOUNDATION
Organization’s Mailing Address 1509 CASTLE HILL AVENUE
City BRONX
State NY
ZIP 10462
Accounting period End 12
Primary contact name PHOTIS C SAVVIDES CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SAMUEL QUARLEY
PRESIDENT
5023 SPRUCE STREET
PHILADELPHIA PA 19139-4116

Officer/Director/Trustee Two

RALPH SMITH
VICE PRESIDENT
62 CHIPENAHAM DRIVE
VOORHES NY 08043

Officer/Director/Trustee Three

JONATHAN LARYEA
SECRETARY
1509 CASTLE HILL
BRONX NY 10462

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/24/2011
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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