FORM 1023-EZ for MUTUAL UNION OF TIV IN AMERICA

Field Data
EIN 81-5232275
Case Number EO-2021099-000286
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MUTUAL UNION OF TIV IN AMERICA
Organization’s Mailing Address 135 STRANDHILL ROAD
City TYRONE
State GA
ZIP 30290
Accounting period End 12
Primary contact name TERVER ASSOH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERVER ASSOH
FINANCIAL SECRETARY
320 E CANEDY APT 5
SPRINGFIELD IL 62703

Officer/Director/Trustee Two

SIMON KUSUGH
PRESIDENT
13150 BISSONNET STREET
HOUSTON TX 77099

Officer/Director/Trustee Three

DANIEL ANYANGAKAA
VICE PRESIDENT
1317 ABINGTON DRIVE
MEBANE SC 27302

Officer/Director/Trustee Four

BEEIOR ROV-IKPAH
SECRETARY
410 N CIVIC DRIVE
WALNUT CREEK CA 94596

Officer/Director/Trustee Five

SANDY BULA
TREASUER
5815 CREEKTRACE LN
KATY TX 77449

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 Yes
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TERVER ASSOH
Signature Title FINANCIAL SECRETARY
Signature Date 3/24/2021
EIN 81-5232275
Case Number EO-2017038-000045
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MUTUAL UNION OF TIV IN AMERICA - MUTA
Organization’s Mailing Address 135 STRANDHILL ROAD
City TYRONE
State GA
ZIP 30290
Accounting period End 12
Primary contact name HENRY K MNGEREM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HENRY MNGEREM
PRESIDENT
135 STRANDHILL
TYRONE GA 30290

Officer/Director/Trustee Two

SIMON KUSUGH
VICE PRESIDENT
11850 FM 1960 ROAD W
HOUSTON TX 77065

Officer/Director/Trustee Three

TERSEER HEMBEN
SECRETARY
1377 KEPPEN BLVD
LINCOLN PARK MI 48146

Officer/Director/Trustee Four

TERVER MYADZE
FINANCIAL SECRETARY
234 WEST18TH AVE SUITE 3462
COLUMBUS OH 43210

Officer/Director/Trustee Five

DOMINIQUE MBACHIE
TREASURER
5872 EASTERN AVENUE NE
WASHINGTON DC 20011

Organization’s website WWW.MUTA.ORG
Organization’s email MUTAPRESIDENT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 Yes
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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