FORM 1023-EZ for WEST MICHIGAN SOMALI BANTU COMMUNITY SERVICE

Field Data
EIN 47-5114678
Case Number EO-2016102-000395
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WEST MICHIGAN SOMALI BANTU COMMUNITY SERVICE
Organization’s Mailing Address 3674 CAMELOT DR SE 2B
City GRAND RAPIDS
State MI
ZIP 49546
Accounting period End 12
Primary contact name ABDIWAHAB OSMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ABDIWAHAB OSMAN
PRESIDENT
3674 CAMELOT DR SE 2B
GRAND RAPIDS MI 49546

Officer/Director/Trustee Two

JOHARA SALAT
VICE PRESIDENT
49 ANTOINE ST SW
GRAND RAPIDS MI 49507

Officer/Director/Trustee Three

SALIM SHONGOLO
TREASURER
846 GENEVA AVE SE
GRAND RAPIDS MI 49507

Officer/Director/Trustee Four

HUSSEIN AHMED
SECRETARY
3674 CAMELOT DR SE 2B
GRAND RAPIDS MI 49546

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/18/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other 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 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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