FORM 1023-EZ for 100 BLACK MEN OF SEATTLE

Field Data
EIN 82-1221541
Case Number EO-2017208-000281
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 100 BLACK MEN OF SEATTLE
Organization’s Mailing Address 3703 S EDMUNDS ST 98
City SEATTLE
State WA
ZIP 98118
Accounting period End 12
Primary contact name ERWIN CHAPPEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERWIN CHAPPEL
PRESIDENT/CEO
8019 S 117TH ST
SEATTLE WA 98178

Officer/Director/Trustee Two

JJEFFERSON BUTLER
V.P./ MENTORING CHAIR
330 SW 43 ST STE 600
RENTON WA 98057

Officer/Director/Trustee Three

RON BENNETT
TREASURER
900 SW 16 ST STE 130
RENTON WA 98057

Officer/Director/Trustee Four

MICHAEL CLARK
SECRETARY
14140 SE 171 ST WY UNIT E303
RENTON WA 98058

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/18/2017
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O30 - Adult, Child Matching Programs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
One Third Support Gifts Yes
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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