FORM 1023-EZ for AFRICAN DIASPORA HEALTH CARE INITIATIVE

Field Data
EIN 85-3575377
Case Number EO-2021063-000052
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AFRICAN DIASPORA HEALTH CARE INITIATIVE
Organization’s Mailing Address 154 REID LANE
City RICHMOND
State CA
ZIP 94801
Accounting period End 12
Primary contact name RONALD GEORGE BANKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RAYMOND CHEMEZIE
PRESIDENT/DIRECTOR
154 REID LANE
RICHMOND CA 94801

Officer/Director/Trustee Two

RONALD BANKS
TREASURER/DIRECTOR
25976 CLAUSEN CT
HAYWARD CA 94541

Officer/Director/Trustee Three

LETHA QUASHIE
SECRETARY/DIRECTOR
2 CLIMBING ROSE COURT
THE WOODLANDS CA 77385

Officer/Director/Trustee Four

BENO TANO
DIRECTOR
4205 MONTREAL STREET UNIT 205
BISMARCK ND 58503

Officer/Director/Trustee Five

KOFI TAWIAH
DIRECTOR
3594 ELLERY COMMON
FREMONT CA 94538

Organization’s website
Organization’s email NORBELS10@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/12/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E32 - Ambulatory Health Center, Community Clinic
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 RAYMOND CHEMEZIE
Signature Title PRESIDENT/DIRECTOR
Signature Date 12/31/2020

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