FORM 1023-EZ for THE BLACK LIGHT FOUNDATION
| Field | Data |
|---|---|
| EIN | 84-2503814 |
| Case Number | EO-2019247-000208 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | THE BLACK LIGHT FOUNDATION |
| Organization’s Mailing Address | 4 PISGAH FOREST CIRCLE |
| City | GREENSBORO |
| State | NC |
| ZIP | 27455-2845 |
| Accounting period End | 12 |
| Primary contact name | TRISTAN MARROW |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JALAH CLAYTON
PRESIDENT
10502 DRAKE HILL DRIVE
HUNTERSVILLE NC 28078-5396
Officer/Director/Trustee Two
TRISTAN MARROW
TREASURER
4 PISGAH FOREST CIRCLE
GREENSBORO NC 27455-2845
Officer/Director/Trustee Three
CORY BENNETT
BOARD OF DIRECTOR
6300 ROCKSHIRE DRIVE
CHARLOTTE NC 28227-8057
Officer/Director/Trustee Four
TIFFANY ROWELL
BOARD OF DIRECTOR
3766 CASCADES BLVD APT 205
KENT OH 44240-8044
Officer/Director/Trustee Five
LESLEY POLLARD
BOARD OF DIRECTOR
273 CLIFTON PLACE UNIT 2B
BROOKLYN NY 11216-4948
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/18/19 |
| Organization Incorporation State | NC |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P20 - Human Service Organizations - Multipurpose |
| 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 | TRISTAN MARROW |
| Signature Title | TREASURER |
| Signature Date | 9/2/19 |
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