FORM 1023-EZ for BLACK IS GOLD ORGANIZATION NFP

Field Data
EIN 82-3071341
Case Number EO-2017313-000067
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLACK IS GOLD ORGANIZATION NFP
Organization’s Mailing Address 2828 WEST 84TH
City CHICAGO
State IL
ZIP 60652
Accounting period End 12
Primary contact name ROSEZENA J PIERCE ATTORNEY AT LAW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DURRELL ANDERSON
CHIEF EXECUTIVE OFFICER
2828 WEST 84TH STREET
CHICAGO IL 60652

Officer/Director/Trustee Two

AMBER ANDERSON
EXECUTIVE DIRECTOR OF OPS
2828 WEST 84TH STREET
CHICAGO IL 60652

Officer/Director/Trustee Three

JILLIAN SHOGUNLE
DIRECTOR OF COMMUNICATIONS
15843 TURNER
MARKHAM IL 60428

Officer/Director/Trustee Four

LAILAH WEBSTER
FINANICAL OFFICER
7325 SOUTH WABASH
CHICAGO IL 60619

Officer/Director/Trustee Five

PAMELA SHIRLEY
BOARD MEMBER
7601 SOUTH CHAPPEL
CHICAGO IL 60649

Organization’s website WWW.BLACKISGOLDCHI.ORG
Organization’s email BLACKISGOLD17@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/3/2017
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
Donation of funds Yes
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
Signature Title
Signature Date

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