FORM 1023-EZ for MY BROTHERS KEEPER INTERNATIONAL INC

Field Data
EIN 82-1925112
Case Number EO-2018348-000164
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MY BROTHERS KEEPER INTERNATIONAL INC
Organization’s Mailing Address 19 SANDS POINT ROAD
City PORT WASHINGTON
State NY
ZIP 11050-1625
Accounting period End 12
Primary contact name DR GRACE FORDE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GRACE FORDE
PRESIDENT
19 SANDS POINT ROAD
PORT WASHINGTON NY 11050

Officer/Director/Trustee Two

JOSHUA SHERER
TREASURER
336 W 11TH STREET
NEW YORK NY 10014

Officer/Director/Trustee Three

LEISA ALLEN-WARREN
VICE PRESIDENT
48 PORTERFIELD PLACE
FREEPORT NY 11520

Officer/Director/Trustee Four

REGINALD WARREN
DIRECTOR
48 PORTERFIELD PLACE
FREEPORT NY 11520

Officer/Director/Trustee Five

VERNETTE ANDERSON
ASSISTANT DIRECTOR
588 PAFF AVENUE
UNIONDALE NY 11553

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/21/15
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P19 - Nonmonetary Support 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 No
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 GRACE FORDE
Signature Title PRESIDENT
Signature Date 12/12/18

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