FORM 1023-EZ for DALE BROWN BOYS AND GIRLS BASKETBALL SPORTS ACADEMY

Field Data
EIN 47-3568802
Case Number EO-2015183-000291
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DALE BROWN BOYS AND GIRLS BASKETBALL SPORTS ACADEMY
Organization’s Mailing Address 4315 ORCHARD AVENUE SUITE 53
City PASCAGOULA
State MS
ZIP 39581
Accounting period End 12
Primary contact name YA-SIN SHABAZZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DALE BROWN
PRESIDENT/CEO-EXEC. DIRECTOR
4315 ORCHARD AVENUE SUITE 53
PASCAGOULA MS 39581

Officer/Director/Trustee Two

SHAHEED ABDUL-ALI
DIRECTOR
1527 19TH ST
GULFPORT MS 39501

Officer/Director/Trustee Three

YA-SIN SHABAZZ
DIRECTOR
340 MENGE AVE
PASS CHRISTIAN MS 39571

Officer/Director/Trustee Four

JAMES PETERS
DIRECTOR
205 KELLER AVE
BILOXI MS 39530

Officer/Director/Trustee Five

JADA MUHAMMAD
DIRECTOR
205 KELLER AVE
BILOXI MS 39530

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/2015
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
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
Signature Title
Signature Date

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