FORM 1023-EZ for CAMPAIGN FOR BLACK MEN MN INC

Field Data
EIN 87-1165872
Case Number EO-2021165-000655
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAMPAIGN FOR BLACK MEN MN INC
Organization’s Mailing Address 3242 WASHBURN AVENUE NORTH
City MINNEAPOLIS
State MN
ZIP 55412
Accounting period End 12
Primary contact name BREYONNE GOLDING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BREYONNE GOLDING
PRESIDENT
3242 WASHBURN AVENUE NORTH
MINNEAPOLIS MN 55412

Officer/Director/Trustee Two

MARIAH ADANANE
TREASURER
2635 GIRARD AVENUE SOUTH
MINNEAPOLIS MN 55408

Officer/Director/Trustee Three

JESSICA GRIFFIN
SECRETARY
2224 MAYFAIR ROAD
MINNEAPOLIS MN 55427

Organization’s website CAMPAIGNFORBLACKMEN.COM
Organization’s email INFO@CAMPAIGNFORBLACKMEN.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/2021
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, 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 BREYONNE GOLDING
Signature Title PRESIDENT
Signature Date 6/11/2021

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