FORM 1023-EZ for FANNY MEMORIAL FOUNDATION INC

Field Data
EIN 81-4679090
Case Number EO-2017263-000078
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FANNY MEMORIAL FOUNDATION INC
Organization’s Mailing Address 1101 1ST STREET E
City WEST FARGO
State ND
ZIP 58078
Accounting period End 12
Primary contact name PAUL AGAMIRI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL AGAMIRI
PRES
5169 9TH AVE SOUTH
FARGO ND 58103

Officer/Director/Trustee Two

DOMINIC NUNU
TRES
149-37 256 STREET
ROSEDALE NY 11422

Officer/Director/Trustee Three

JOE GBASSAGEE
SEC
3301 32ND STREET SOUTH APT 204
FARGO ND 58104

Organization’s website
Organization’s email PATRICIAVERDIER22@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/19/2017
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
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
Signature Title
Signature Date

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