FORM 1023-EZ for UNITED SIXTIES BORN OF GRAND GEDEHCOUNTY IN THE AMERICAS

Field Data
EIN 81-3372063
Case Number EO-2016216-000109
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UNITED SIXTIES BORN OF GRAND GEDEHCOUNTY IN THE AMERICAS
Organization’s Mailing Address 2112 S 66TH ST
City PHILADELPHIA
State PA
ZIP 19142
Accounting period End 12
Primary contact name SAM SHAKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAM SHAKA
PRESIDENT
2112 S 66TH ST
PHILADELPHIA PA 19142

Officer/Director/Trustee Two

ERIC GOAH
SECRETARY
2112 S 66TH ST
PHILADELPHIA PA 19142

Officer/Director/Trustee Three

MORRIS JELLUE
TREASURER
2106 FOREST AVENUE
DES MOINES IA 50311

Officer/Director/Trustee Four

AUGUSTUS KRAH
DIRECTOR
677 26TH STREET
DES MOINES IA 50312

Officer/Director/Trustee Five

ELIZA GLEPLAY
DIRECTOR
2112 SOUTH 66TH STREET
PHILADELPHIA PA 19142

Organization’s website
Organization’s email SSHAKA76@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S21 - Community Coalitions
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 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
Signature Title
Signature Date

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