FORM 1023-EZ for 100 BLACK MEN OF VALDOSTA INC

Field Data
EIN 58-2201428
Case Number EO-2019092-000471
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 100 BLACK MEN OF VALDOSTA INC
Organization’s Mailing Address 401 E MARTIN LUTER KING JR DRIVE
City VALDOSTA
State GA
ZIP 31601
Accounting period End 12
Primary contact name JEREMIAH LAWTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NATHANIEL HAUGABROOK
PRESIDENT
104 ADAIR STREET
VALDOSTA GA 31601

Officer/Director/Trustee Two

DAVID TROY
VICE PRESIDENT
3106 FALLING LEAF
VALDOSTA GA 31602

Officer/Director/Trustee Three

OSCAR LEE
SECRETARY
3311 CHARDON WAY
VALDOSTA GA 31602

Officer/Director/Trustee Four

JEREMIAH LAWTON
TREASURER
2315 COREY DRIVE
VALDOSTA GA 31601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/21/95
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 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 Yes
Correctness Declaration Yes
Signature Name JEREMIAH LAWTON
Signature Title TREASURER
Signature Date 3/29/19

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