FORM 1023-EZ for MY BROTHERS KEEPER MENTORSHIP PROGRAM

Field Data
EIN 82-0914216
Case Number EO-2018095-000519
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MY BROTHERS KEEPER MENTORSHIP PROGRAM
Organization’s Mailing Address 805 9TH AVENUE
City BEAVER FALLS
State PA
ZIP 15010
Accounting period End 12
Primary contact name TONETTE WHITTED
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TONETTE WHITTED
FOUNDER/EXECUTIVE DIRECTOR
805 9TH AVENUE
BEAVER FALLS PA 15010

Officer/Director/Trustee Two

ROCKY WASHINGTON
CHAIRMAN
403 35TH STREET
BEAVER FALLS PA 15010

Officer/Director/Trustee Three

SANNA CLARK
VICE-CHAIRMAN
415 16TH STREET
BEAVER FALLS PA 15010

Officer/Director/Trustee Four

CYNTHIA COOK
SECRETARY
4720 5TH AVENUE
BEAVER FALLS PA 15010

Officer/Director/Trustee Five

JOHNETTA BROWN
TREASURER
805 9TH AVENUE
BEAVER FALLS PA 15010

Organization’s website
Organization’s email BKEEPERS21@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/16/17
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O30 - Adult, Child Matching Programs
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TONETTE WHITTED
Signature Title FOUNDER/EXECUTIVE DIRECTOR
Signature Date 3/21/18

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