FORM 1023-EZ for THE BELOVED COMMUNITY INC

Field Data
EIN 82-1694115
Case Number EO-2018110-000139
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE BELOVED COMMUNITY INC
Organization’s Mailing Address 1779 KIRBY PKWY SUITE 1 322
City MEMPHIS
State TN
ZIP 38138
Accounting period End 12
Primary contact name DR GEORGE CAMPBELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID BLACK
PRESIDENT
1779 KIRBY PKWY SUITE 1 322
MEMPHIS TN 38138

Officer/Director/Trustee Two

RITA BLACK
TREASURER
1779 KIRBY PKWY SUITE 1 322
MEMPHIS TN 38138

Officer/Director/Trustee Three

RACHEL BLACK
SECRETARY
1779 KIRBY PKWY SUITE 1 322
MEMPHIS TN 38138

Officer/Director/Trustee Four

DR GEORGE CAMPBELL
BOARD MEMBER
1779 KIRBY PKWY SUITE 1 322
MEMPHIS TN 38138

Officer/Director/Trustee Five

WINSTON YATES
BOARD MEMBER
1779 KIRBY PKWY SUITE 1 322
MEMPHIS TN 38138

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/30/17
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
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 Yes
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 DAVID BLACK
Signature Title PRESIDENT
Signature Date 4/18/18

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