FORM 1023-EZ for ROBERT EARL GLOVER JR FOUNDATION

Field Data
EIN 90-0848534
Case Number EO-2016312-000460
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROBERT EARL GLOVER JR FOUNDATION
Organization’s Mailing Address 3850 PATE STREET
City ORANGEBURG
State SC
ZIP 29118
Accounting period End 12
Primary contact name DAISY GLOVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAISY GLOVER
EXECUTIVE DIRECTOR
3850 PATE STREET
ORANGEBURG SC 29118

Officer/Director/Trustee Two

NATECHA LESTER - JOHNSON
BOARD CHAIR
1594 BLUE SPRUCE LANE
CONYERS GA 30012

Officer/Director/Trustee Three

SHAYNA KEYES
SECRETARY/BOARD MEMBER
35 S JACKSON STREET APT B
WINDER GA 30680

Officer/Director/Trustee Four

DIANE MAKATA JOHNSON
BOARD MEMBER
604 DELBRIDGE STREET
ATLANTA GA 30314

Officer/Director/Trustee Five

SHARELLE COLEMAN - GLOVER
BOARD MEMBER
8419 106 STREET
RICHMOND HILL NY 11418

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2012
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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